NPIMap

Organization Active NPI

Cora South Carolina LLC

Doing business as CORA Physical Therapy - Mount Pleasant

  • Rehabilitation Clinic/Center
  • Mount Pleasant, SC
National Provider Identifier
1316421571
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CORA SOUTH CAROLINA LLC
Doing business as
CORA Physical Therapy - Mount Pleasant
Practice address
1907 N Highway 17 Ste 102
Mount Pleasant, SC 29464-9604
Phone
(438) 584-8120
Fax
(438) 212-4741
NPI assigned
Sep 24, 2018
Last updated
Nov 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Authorized official

Name
Brad Roush
Title
Executive Vice President
Phone
(419) 221-6712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1907 N Highway 17 Ste 102
Mount Pleasant, SC 29464-9604

Mailing address

1110 Shawnee Rd
Lima, OH 45805-3529
Phone (419) 221-6717

Other names 1

  • CORA Physical Therapy - Mount Pleasant Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181112001214 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3173766334 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charleston, SC; Johns Island, SC; North Charleston, SC; Summerville, SC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542672000000",
    "number": "1316421571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053529",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 N HIGHWAY 17 STE 102",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649604",
            "telephone_number": "438-584-8120",
            "fax_number": "438-212-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORA SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-11-20",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6712"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Mount Pleasant",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Physical Therapy - Mount Pleasant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.