NPIMap

Organization Active NPI

Southern States Physical Therapy LLC

  • Physical Therapist
  • Lancaster, SC
National Provider Identifier
1285024836
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4533 Issued in SC
Legal business name
SOUTHERN STATES PHYSICAL THERAPY LLC
Practice address
106A Woodland Dr
Lancaster, SC 29720-4707
Phone
(803) 283-8442
Fax
(803) 286-4604
NPI assigned
Feb 3, 2015
Last updated
Aug 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Mr. Ryan Christopher Faker, MSPTNPI 1881029676
Title
Owner/Physical Therapist
Phone
(704) 578-0641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4533 SC Primary

Addresses

Primary practice location

106A Woodland Dr
Lancaster, SC 29720-4707

Mailing address

2670 Mills Park Dr
Rock Hill, SC 29732-8599
Phone (803) 324-3745

Other identifiers 1

IdentifierTypeStateIssuer
13501810OtherSCCAQH

National Provider Directory

National Provider Directory

Locations

106 Woodland Dr
#A
Lancaster, SC 29720
Phone (803) 283-8442

106A Woodland Dr
Lancaster, SC 29720
Phone (803) 283-8442

2670 Mills Park Dr
Rock Hill, SC 29732
Phone (803) 366-4848

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1285024836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 MILLS PARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328599",
            "telephone_number": "803-324-3745",
            "fax_number": "803-324-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106A WOODLAND DR",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297204707",
            "telephone_number": "803-283-8442",
            "fax_number": "803-286-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN STATES PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "FAKER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "704-578-0641",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13501810",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.