NPIMap

Organization Active NPI

Clemson Sports Medicine and Rehabilitation Inc

  • Rehabilitation Hospital Unit
  • Seneca, SC
National Provider Identifier
1275530503
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
CLEMSON SPORTS MEDICINE AND REHABILITATION INC
Practice address
10626 Clemson Blvd
Seneca, SC 29678-4526
Phone
(864) 482-0064
Fax
(864) 482-0074
NPI assigned
Jul 1, 2005
Last updated
Nov 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Authorized official

Name
Ms. Charleen Fitzgerald
Title
Credentialing
Phone
(864) 482-0064

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Hospital Unit 273Y00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

10626 Clemson Blvd
Seneca, SC 29678-4526

Mailing address

PO Box 1844
Clemson, SC 29633-1844
Phone (864) 482-0064

Other identifiers 1

IdentifierTypeStateIssuer
5092260001OtherSCDMERC

National Provider Directory

National Provider Directory

Locations

1397 Silver Bluff Rd
Aiken, SC 29803
Phone (803) 220-1073

1007 Tiger Blvd
Clemson, SC 29631

1019 Tiger Blvd
Clemson, SC 29631
Phone (864) 654-0431

2 Medical Park Rd
Ste 304
Columbia, SC 29203

838 Powdersville Rd
Ste T
Easley, SC 29642
Phone (864) 671-1650

1909 N Highway 17
Ste 220
Mount Pleasant, SC 29464

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

119 Office Park Dr
Orangeburg, SC 29118
Phone (803) 536-5509

12023 N Radio Station Rd
Seneca, SC 29678
Phone (864) 985-0770

10626 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0064

522 N Magnolia St
Ste A
Summerville, SC 29483
Phone (843) 376-5963

Practitioners & affiliated clinicians

Practitioners 10

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": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1275530503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296331844",
            "telephone_number": "864-482-0064",
            "fax_number": "864-482-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10626 CLEMSON BLVD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784526",
            "telephone_number": "864-482-0064",
            "fax_number": "864-482-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "CHARLEEN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "864-482-0064",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5092260001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.