Michael Waters, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070019603 Issued in IL

Practice address

35 Ray E Talley CT
Simpsonville, SC 29680-6772

Phone

(864) 967-4600

NPI assigned

Nov 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Physical Therapy LLCGroup PAC ID 2769915347, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Novant Health Physical Therapy LLC

  dba Novant Health Physical Therapy

  • Physical Therapist
  • Port Royal, SC
  • NPI 1376379818
  Medicare reassignment Care Compare group NPD
• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment NPD
• Greenville Proaxis Therapy LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1255675427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RAY E TALLEY CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806772",
            "telephone_number": "864-967-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1938 E Lincoln Hwy",
            "address_2": "Suite 111",
            "address_purpose": "LOCATION",
            "city": "New Lenox",
            "state": "IL",
            "postal_code": "604513810",
            "country_code": "US",
            "telephone_number": "815-485-2916",
            "fax_number": "815-485-2918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyla Farhah Warsi, DMD
• Stefanie Washburn, MS, ATC
• Emily Victoria Washington
• Jacquelyn Washington
• Keith H Waters, MD
• Anna Watkins
• Derek Scott Watson, MD
• Loren Watts, LPC
• Brian Alexander Weatherby, MD
• Christina Roth Weddington, FNP

• Physical Therapist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.