Individual provider Active NPI

Janine Carla Dijan Sunga, DPT

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1285476457
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12329 Issued in SC
Practice address
655 Fairview Rd Ste F
Simpsonville, SC 29680-6777
Phone
(864) 686-5991
NPI assigned
Jun 10, 2024
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040650 NY
Physical Therapist 225100000X
Physical Therapist 225100000X 12329 SC Primary

Addresses

Primary practice location

655 Fairview Rd Ste F
Simpsonville, SC 29680-6777

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

2646 Boiling Springs Rd
Boiling Springs, SC 29316-6002
Phone (864) 345-6714

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925004005 SC Practitioner - Physical Therapist in Private Practice 0749721140 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12329SCMDSocial Worker
040650NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Health Services Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Jul 1, 2024 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

2646 Boiling Springs Rd
Boiling Springs, SC 29316
Phone (864) 345-6714

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

655 Fairview Rd
Ste F
Simpsonville, SC 29680
Phone (864) 686-5991

2125 E Main St
Unit B
Spartanburg, SC 29307
Phone (864) 285-3615

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1285476457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 FAIRVIEW RD STE F",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806777",
            "telephone_number": "864-686-5991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2646 Boiling Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "SC",
            "postal_code": "293166002",
            "country_code": "US",
            "telephone_number": "864-345-6714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNGA",
        "first_name": "JANINE CARLA",
        "middle_name": "DIJAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040650",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.