NPIMap

Individual provider Active NPI

Erin Teal Jacobson, PT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1255572376
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5904 Issued in SC
Practice address
3010 Farrow Rd
Ste 120
Columbia, SC 29203-7607
Phone
(803) 434-7750
Fax
(803) 434-2983
NPI assigned
Mar 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5904 SC Primary

Addresses

Primary practice location

3010 Farrow Rd
Ste 120
Columbia, SC 29203-7607

Mailing address

3010 Farrow Rd
Ste 120
Columbia, SC 29203-7607
Phone (803) 434-7750

Other names 1

  • Erin Teal Watson Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Past Accepting new patients
Proaxis Spartanburg, LLC Physical Therapist Past Accepting new patients
Greenville Proaxis Therapy LLC Past Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1255572376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 FARROW RD",
            "address_2": "STE 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037607",
            "telephone_number": "803-434-7750",
            "fax_number": "803-434-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 FARROW RD",
            "address_2": "STE 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037607",
            "telephone_number": "803-434-7750",
            "fax_number": "803-434-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ERIN",
        "middle_name": "TEAL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "WATSON",
            "middle_name": "TEAL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.