Individual provider Active NPI

Kylah Moshae George, PT, DPT

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1306682596
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12824 Issued in SC
Practice address
857 Promenade Walk
Fort Mill, SC 29708-6992
Phone
(803) 547-1133
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP041063T OH
Physical Therapist 225100000X 12824 SC Primary
Physical Therapist 225100000X P22054 NC

Addresses

Primary practice location

857 Promenade Walk
Fort Mill, SC 29708-6992

Mailing address

8918 Blakeney Professional Dr Ste 120
Charlotte, NC 28277-6692
Phone (704) 900-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240925003964 OH Practitioner - Physical Therapist in Private Practice 0840731246 Reassigns benefits to 1 organization
I20250506000443 SC Practitioner - Physical Therapist in Private Practice 0840731246 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12824SCMDPharmacist
P22054NCMDPhysical Therapist
CP041063TOHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Architech Sports and Physical Therapy, LLC Physical Therapist CurrentSince Apr 29, 2025 Accepting new patients
Drayer Physical Therapy Northern Ohio LLC Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Ultra Sports Performance, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Architech Sports and Physical Therapy, LLC PastSince Apr 29, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1429 Bryant St
Ste A
Charlotte, NC 28208
Phone (704) 919-0867

7733 Ballantyne Commons Pkwy
Ste 103
Charlotte, NC 28277
Phone (704) 236-0222

8918 Blakeney Professional Dr
Ste 120
Charlotte, NC 28277
Phone (704) 609-0357

108 Barrington Town Square Dr
Aurora, OH 44202
Phone (330) 562-1655

4682 Cemetery Rd
Hilliard, OH 43026
Phone (614) 819-1000

857 Promenade Walk
Fort Mill, SC 29708
Phone (803) 547-1133

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1306682596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8918 BLAKENEY PROFESSIONAL DR STE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776692",
            "telephone_number": "704-900-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 PROMENADE WALK",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086992",
            "telephone_number": "803-547-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KYLAH",
        "middle_name": "MOSHAE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "CP041063T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12824",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.