Active NPI
Ellen Fay Patrick, PT
- Physical Therapist
- Orangeburg, SC
National Provider Identifier
1245459007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3354
- Practice address
- 119 Office Park Dr
Orangeburg, SC 29118-2407 - Phone
- (803) 536-5509
- Fax
- (843) 536-4104
- NPI assigned
- Apr 24, 2007
- Last updated
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3354 | SC | Primary |
Addresses
Primary practice location
119 Office Park Dr
Orangeburg, SC 29118-2407
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3354 | SC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services of South Carolina, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Lexington, SC
- NPI 1902133689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1245459007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 OFFICE PARK DR",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291182407",
"telephone_number": "803-536-5509",
"fax_number": "843-536-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "ELLEN",
"middle_name": "FAY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "3354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orangeburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.