NPIMap

Organization Active NPI

Faithworks Pediatric Innervations, Inc

  • Physical Therapist
  • Lake City, SC
National Provider Identifier
1265571558
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4703 Issued in SC
Legal business name
FAITHWORKS PEDIATRIC INNERVATIONS, INC
Practice address
318 Moore St
Lake City, SC 29560-2551
Phone
(843) 394-9799
Fax
(843) 394-9899
NPI assigned
Feb 5, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Betty McKenzie, SPEECH PATHOLOGISTNPI 1194926881
Title
Owner
Phone
(843) 394-9799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4703 SC Primary
Physical Therapy Assistant 225200000X 177 SC
Speech-Language Pathologist 235Z00000X 1113 SC

Addresses

Primary practice location

318 Moore St
Lake City, SC 29560-2551

Mailing address

300 Thurston St
Lake City, SC 29560-2527
Phone (843) 394-9799

Other identifiers 1

IdentifierTypeStateIssuer
GP3696MedicaidSC

National Provider Directory

National Provider Directory

Locations

318 Moore St
Lake City, SC 29560
Phone (843) 394-9799

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1265571558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 THURSTON ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602527",
            "telephone_number": "843-394-9799",
            "fax_number": "843-394-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MOORE ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602551",
            "telephone_number": "843-394-9799",
            "fax_number": "843-394-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITHWORKS PEDIATRIC INNERVATIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-394-9799",
        "authorized_official_credential": "SPEECH PATHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4703",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "177",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "1113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3696",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.