Organization Active NPI

Powerback Pediatrics of South Carolina LLC

  • Behavior Analyst
  • Charleston, SC
National Provider Identifier
1295580884
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
POWERBACK PEDIATRICS OF SOUTH CAROLINA LLC
Practice address
174 Meeting St Ste 300
Charleston, SC 29401-3211
Phone
(888) 269-9876
NPI assigned
Apr 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Paige McComas
Title
SVP
Phone
(947) 228-4199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

174 Meeting St Ste 300
Charleston, SC 29401-3211

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (800) 728-8808

National Provider Directory

National Provider Directory

Locations

174 Meeting St
Ste 300
Charleston, SC 29401
Phone (516) 458-4366

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1295580884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-728-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MEETING ST STE 300",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294013211",
            "telephone_number": "888-269-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK PEDIATRICS OF SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "MCCOMAS",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "947-228-4199"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.