Individual provider Active NPI

Ingrid C. Thomas, P.T.

  • Pediatric Physical Therapist
  • Summerville, SC
National Provider Identifier
1265607113
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
4437 Issued in SC
Practice address
106 Boone Dr
Summerville, SC 29485-3413
Phone
(843) 509-6626
Fax
(843) 821-5859
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4437 SC
Pediatric Physical Therapist 2251P0200X 4437 SC Primary

Addresses

Primary practice location

106 Boone Dr
Summerville, SC 29485-3413

Mailing address

106 Boone Dr
Summerville, SC 29485-3413
Phone (843) 509-6626

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1265607113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BOONE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294853413",
            "telephone_number": "843-509-6626",
            "fax_number": "843-821-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BOONE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294853413",
            "telephone_number": "843-509-6626",
            "fax_number": "843-821-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "INGRID",
        "middle_name": "C.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4437",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.