NPIMap

Organization Active NPI

Imc of South Carolina

  • Physical Therapist
  • Anderson, SC
National Provider Identifier
1265855332
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6669 Issued in SC
Legal business name
IMC OF SOUTH CAROLINA
Practice address
1 Bib Way
Anderson, SC 29626-6047
Phone
(850) 656-1837
NPI assigned
Jan 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Mrs. Tara N. Atkinson
Title
Insurance & Billing Coordinator
Phone
(850) 656-1837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 6669 SC Primary

Addresses

Primary practice location

1 Bib Way
Anderson, SC 29626-6047

Mailing address

2615 Centennial Blvd
Suite 101
Tallahassee, FL 32308-0586
Phone (850) 656-1837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121102000254 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395996185 Receives reassigned benefits from 1 practitioner
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Greenville, SC; Lexington, SC; Sandy Springs, SC; Spartanburg, SC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Imc of South Carolina6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Bib Way
Anderson, SC 29626
Phone (864) 458-1894

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": "1390780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1265855332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CENTENNIAL BLVD",
            "address_2": "SUITE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080586",
            "telephone_number": "850-656-1837",
            "fax_number": "850-877-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BIB WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296266047",
            "telephone_number": "850-656-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC OF SOUTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "INSURANCE & BILLING COORDINATOR",
        "authorized_official_telephone_number": "850-656-1837",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.