Individual provider Active NPI

Marianne Carolina Weichselbaumer

  • Physical Therapist
  • Sumter, SC
National Provider Identifier
1255802336
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.9443 Issued in SC
Practice address
75 W Wesmark Blvd
Sumter, SC 29150-1955
Phone
(803) 938-5395
Fax
(803) 938-5396
NPI assigned
Dec 16, 2018
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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 PT.9443 SC Primary

Addresses

Primary practice location

75 W Wesmark Blvd
Sumter, SC 29150-1955

Mailing address

141 Atrium Way
Columbia, SC 29223-6301
Phone (803) 788-8484

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

LicenseStateTypeSpecialty
9443SCMDPharmacist
PT.9443SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Feb 7, 2022 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Feb 7, 2022 Accepting new patients
Carolina Physical Therapy and Sports Medicine, Inc. CurrentSince Dec 17, 2018 Accepting new patients

Locations

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

75 W Wesmark Blvd
Sumter, SC 29150
Phone (800) 456-5857

19505 7th Ave NE
Poulsbo, WA 98370
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1255802336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 ATRIUM WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236301",
            "telephone_number": "803-788-8484",
            "fax_number": "803-788-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501955",
            "telephone_number": "803-938-5395",
            "fax_number": "803-938-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEICHSELBAUMER",
        "first_name": "MARIANNE",
        "middle_name": "CAROLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT.9443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.