Marissa Slate, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT 8191 Issued in SC

Practice address

9565 Highway 78 Ste 102
Ladson, SC 29456-4118

Phone

(843) 314-5434

Fax

(888) 510-9156

NPI assigned

Jul 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Milestones & Movement Pediatric Physical Therapy, LLC

  • Pediatric Physical Therapist
  • Summerville, SC
  • NPI 1982221016

  Pediatrics

  NPD Authorized official
• Tri-County Therapy, LLC

  • Speech-Language Pathologist
  • Ladson, SC
  • NPI 1447591607
  NPD (past)

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1306298443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9565 HWY 78 BLDG 700 STE 102",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564116",
            "telephone_number": "843-314-5434",
            "fax_number": "888-510-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9565 HIGHWAY 78 STE 102",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564118",
            "telephone_number": "843-314-5434",
            "fax_number": "888-510-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATE",
        "first_name": "MARISSA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT31544",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "PT 8191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shout Eat Play
• Loren Simms
• Simply Strong Physical Therapy LLC
• Carolyn Simpson
• Mary Skelton
• Douglas E Sloan, DO
• Sharana Sloss, LISW-CP
• Emma Small, PT, DPT
• Ashley D. Smith-Willis
• Anna Ingold Smith, OTR/L

• Pediatric Physical Therapist in Ladson, SC
• Providers in Ladson, SC by specialty
• Pediatric Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.