Wanda Bacher Elliott, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9974 Issued in SC

Practice address

29 N Academy St
Greenville, SC 29601-2629

Phone

(864) 331-1350

NPI assigned

Nov 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wanda Bacher Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Greenville Proaxis Therapy, LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment NPD
• Greenville Proaxis Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD
• Tri-County Therapy, LLC

  • Speech-Language Pathologist
  • Ladson, SC
  • NPI 1447591607

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1306480124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N ACADEMY ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012629",
            "telephone_number": "864-331-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3851 Commercial Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ladson",
            "state": "SC",
            "postal_code": "294564146",
            "country_code": "US",
            "telephone_number": "843-314-5434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "WANDA",
        "middle_name": "BACHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "9974",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "BACHER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mitchell F Ellett Jr., DMD
• Dawn Wright Ellington, COTA/L
• Holly Paine Ellingworth, O.T.
• Blair Worthington Elliott, MSP
• Paige Shone Elliott, DMD
• Jaime Elyse Elliotte, APRN
• Brittany Pirko Ellis, RN, MSN, FNP-C
• Grace Marie Ellis, OT
• James Madison Ellis, MD
• Kristin Jennifer Ellis, OTR/L

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.