Individual provider Active NPI

Melissa Brickson, DPT

  • Orthopedic Physical Therapist
  • Okatie, SC
National Provider Identifier
1306159595
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
6234 Issued in SC
Practice address
4 Okatie Center Blvd S Ste 101
Okatie, SC 29909-7530
Phone
(843) 705-9480
Fax
(843) 705-9481
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 6234 SC Primary

Addresses

Primary practice location

4 Okatie Center Blvd S Ste 101
Okatie, SC 29909-7530

Mailing address

4 Okatie Center Blvd S
Okatie, SC 29909-7529
Phone (843) 705-9480

Other identifiers 1

IdentifierTypeStateIssuer
TH2838MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000961 SC Practitioner - Physical Therapist in Private Practice 3274712922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy and Sports PerformanceGroup PAC ID 6800961707, 6 clinicians

Practice addresses (Care Compare)

4 Okatie Ctr Blvd S
Suite 101
Bluffton, SC 29909-7530
Phone (843) 705-9480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6234SCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy & Sports Performance Bluffton Orthopedic CurrentSince Apr 25, 2021 Accepting new patients
Elite Physical Therapy & Sports Performance CurrentSince Sep 12, 2010 Accepting new patients
Palmetto Therapy Hhi LLC Orthopedic PastSince Jan 1, 2013 Accepting new patients
Palmetto Therapy Services Orthopedic Past Accepting new patients

Locations

4 Okatie Center Blvd S
Ste 101
Okatie, SC 29909
Phone (501) 348-3776

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1306159595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OKATIE CENTER BLVD S",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299097529",
            "telephone_number": "843-705-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OKATIE CENTER BLVD S STE 101",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299097530",
            "telephone_number": "843-705-9480",
            "fax_number": "843-705-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKSON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SC",
            "license": "6234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH2838",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okatie, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.