Tracey L Manasco

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4479 Issued in SC

Practice address

412 Drive in Lane, Unit D
Moncks Corner, SC 29461

Phone

(843) 761-6732

Fax

(843) 761-6734

NPI assigned

Apr 24, 2009

Last updated

Apr 24, 2009By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elevated Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Charleston, SC
  • NPI 1861964520
  NPD (past) Authorized official

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1316181100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 TALL SAIL DR APT L",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146639",
            "telephone_number": "843-364-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 DRIVE IN LANE, UNIT D",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-761-6732",
            "fax_number": "843-761-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASCO",
        "first_name": "TRACEY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Madigan
• Valarie R. Madison
• Crystal Magazine, MSW
• Lisa M Mahan
• Hannah Kristina Malinen, DPT
• Dana Brooke Mandel, MA, LPC-I, CACP
• Nicholas Mandelis
• Lorna Ann Manglona-Alexander, LPC
• Ashley Elizabeth Manilenko, M.A., CCC-SLP
• Helene Marchand, NP

• Physical Therapist in Moncks Corner, SC
• Providers in Moncks Corner, 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 Apr 24, 2009; 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.