Active NPI
Cassidy Cothran
- Physical Therapy Assistant
- West Columbia, SC
National Provider Identifier
1275358657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4604
- Practice address
- 2993 Sunset Blvd
West Columbia, SC 29169-3421 - Phone
- (803) 939-0026
- NPI assigned
- Nov 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4604 | SC | Primary |
Addresses
Primary practice location
2993 Sunset Blvd
West Columbia, SC 29169-3421
Mailing address
101 Waverly Point Dr
Lexington, SC 29072-1805
Phone (803) 397-6197
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4604 | SC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1275358657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WAVERLY POINT DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290721805",
"telephone_number": "803-397-6197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2993 SUNSET BLVD",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693421",
"telephone_number": "803-939-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTHRAN",
"first_name": "CASSIDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-20",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "4604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.