Individual provider Active NPI

Logan Paul Myrick, PT, DPT

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1265146963
Registry record updated Nov 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP043916T Issued in SC
Practice address
727 SE Main St Ste 200
Simpsonville, SC 29681-3262
Phone
(864) 999-3831
NPI assigned
Jan 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP043916T SC Primary
Physical Therapist 225100000X CP035275T GA
Physical Therapist 225100000X 14748 TN
Physical Therapist 225100000X 304936 CA
Physical Therapist 225100000X PT42664 FL
Physical Therapist 225100000X CP0277702T NC

Addresses

Primary practice location

727 SE Main St Ste 200
Simpsonville, SC 29681-3262

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

161 Pontiac Business Center Dr Ste 1188
Elgin, SC 29045-7123
Phone (803) 708-1536

Other practice location 2

454 N University Drive
Pembroke Commons
Pembroke Pines, FL 33024
Phone (954) 443-1926

Other practice location 3

3575 Durden Dr NE # 304A
Brookhaven, GA 30319-2253
Phone (404) 469-9005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC, MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250520001533 FL Practitioner - Physical Therapist in Private Practice 5193243442 Reassigns benefits to 1 organization
I20250523000239 SC Practitioner - Physical Therapist in Private Practice 5193243442 Reassigns benefits to 4 organizations
I20250916002065 MA Practitioner - Physical Therapist in Private Practice 5193243442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

161 Pontiac Business Ctr Dr
Suite 1188
Elgin, SC 29045-7123
Phone (803) 708-1536

316 Huntington Ave
Boston, MA 02115-5019
Phone (617) 448-7381

727 SE Main St
Suite 200
Simpsonville, SC 29681-3262
Phone (864) 454-6670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304936CAMDPhysical Therapist
PT42664FLMDPhysical Therapist
CP035275TGAMDPhysical Therapist
CP0277702TNCMDPhysical Therapist
CP043916TSCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Nov 20, 2025 Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Mar 18, 2025 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Sep 4, 2025 Accepting new patients
Rehabclinics Pta, Inc. Current Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Nov 20, 2025 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Sep 4, 2025 Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Mar 18, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Apr 25, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1817 E Commercial Blvd
Ft Lauderdale, FL 33308
Phone (954) 836-8980

454 N University Dr
Pembroke Pines, FL 33024
Phone (954) 443-1926

33205 Collection Ctr Dr
Chicago, IL 60693

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

703 Granite St
Ste 3
Braintree, MA 02184

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

161 Pontiac Business Center Dr
Ste 1188
Elgin, SC 29045
Phone (803) 708-1536

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

7955 N Kings Hwy
Ste 330
Myrtle Beach, SC 29572
Phone (843) 945-1815

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

727 SE Main St
Ste 200
Simpsonville, SC 29681
Phone (864) 454-6670

1672 N Main St
Ste 11
Summerville, SC 29486
Phone (843) 289-1456

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764201600000",
    "number": "1265146963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST STE 200",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813262",
            "telephone_number": "864-999-3831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Pontiac Business Center Dr Ste 1188",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "SC",
            "postal_code": "290457123",
            "country_code": "US",
            "telephone_number": "803-708-1536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "454 N University Drive",
            "address_2": "Pembroke Commons",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "33024",
            "country_code": "US",
            "telephone_number": "954-443-1926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3575 Durden Dr NE # 304A",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303192253",
            "country_code": "US",
            "telephone_number": "404-469-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "LOGAN",
        "middle_name": "PAUL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2025-11-27",
        "certification_date": "2025-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "CP043916T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP035275T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14748",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304936",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42664",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP0277702T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2025; 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.