Individual provider Active NPI

Leanna Elizabeth Purvis, DPT

  • Physical Therapist
  • Seneca, SC
National Provider Identifier
1306330352
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9194 Issued in SC
Practice address
12023 N Radio Station Rd # a
Seneca, SC 29678-1143
Phone
(864) 985-0770
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9194 SC Primary

Addresses

Primary practice location

12023 N Radio Station Rd # a
Seneca, SC 29678-1143

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802003189 SC Practitioner - Physical Therapist in Private Practice 9638427966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9194SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Jul 1, 2018 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

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

12023 N Radio Station Rd
#A
Seneca, SC 29678
Phone (864) 985-0770

Organizations & group practices 2

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1306330352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12023 N RADIO STATION RD # A",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296781143",
            "telephone_number": "864-985-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIS",
        "first_name": "LEANNA",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.