Individual provider Active NPI

Carrie Lynne Stiles, MSPT

  • Pediatric Physical Therapist
  • Anderson, SC
National Provider Identifier
1316222060
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
7258 Issued in SC
Practice address
1321 Old Gantt Mill Rd
Anderson, SC 29625-6536
Phone
(864) 780-4040
Fax
(864) 780-4030
NPI assigned
Oct 13, 2011
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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 7258 SC
Physical Therapist 225100000X 40QA0893200 NJ
Pediatric Physical Therapist 2251P0200X 7258 SC Primary

Addresses

Primary practice location

1321 Old Gantt Mill Rd
Anderson, SC 29625-6536

Mailing address

1321 Old Gantt Mill Rd
Anderson, SC 29625-6536
Phone (864) 780-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
40QA0893200NJMDPhysical Therapist
7258SCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Physical Therapy CurrentSince Dec 19, 2011 Accepting new patients

Locations

17 Linden Pl
Ste 103
Red Bank, NJ 07701
Phone (732) 383-6789

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1316222060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 OLD GANTT MILL RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296256536",
            "telephone_number": "864-780-4040",
            "fax_number": "864-780-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 OLD GANTT MILL RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296256536",
            "telephone_number": "864-780-4040",
            "fax_number": "864-780-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "CARRIE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7258",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA0893200",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "7258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.