Organization Active NPI

Matrix Rehabilitation South Carolina, Inc.

  • Physical Therapy Clinic/Center
  • Charleston, SC
National Provider Identifier
1295751378
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MATRIX REHABILITATION SOUTH CAROLINA, INC.
Doing business as
Physical Rehabilitation Services
Practice address
11 Gamecock Ave
Suite 1103
Charleston, SC 29407-3380
Phone
(843) 571-2000
Fax
(843) 571-2619
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Mrs. Jayne Fleck Pool
Title
Chief Compliance Officer
Phone
(469) 467-8705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

11 Gamecock Ave
Suite 1103
Charleston, SC 29407-3380

Mailing address

PO Box 1245
Indiana, PA 15701-5245
Phone (724) 465-3496

Other names 1

  • Physical Rehabilitation Services Doing business as

National Provider Directory

National Provider Directory

Locations

11 Gamecock Ave
Charleston, SC 29407
Phone (843) 571-2000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1295751378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157015245",
            "telephone_number": "724-465-3496",
            "fax_number": "215-413-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GAMECOCK AVE",
            "address_2": "SUITE 1103",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073380",
            "telephone_number": "843-571-2000",
            "fax_number": "843-571-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX REHABILITATION SOUTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "FLECK",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-467-8705",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 23, 2010; 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.