NPIMap

Organization Active NPI

Goose Creek Physical Medicine LLC

  • Physical Medicine & Rehabilitation Physician
  • Goose Creek, SC
National Provider Identifier
1346534781
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GOOSE CREEK PHYSICAL MEDICINE LLC
Practice address
607 Saint James Ave
Suite B
Goose Creek, SC 29445-2773
Phone
(843) 376-5595
Fax
(843) 376-5604
NPI assigned
Jun 2, 2011
Last updated
Jun 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Authorized official

Name
Jens Franzen, DCNPI 1902082951
Title
Owner
Phone
(843) 376-5595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

607 Saint James Ave
Suite B
Goose Creek, SC 29445-2773

Mailing address

607 Saint James Ave
Suite B
Goose Creek, SC 29445-2773
Phone (843) 376-5595

Other identifiers 1

IdentifierTypeStateIssuer
CH2773MedicaidSC

National Provider Directory

National Provider Directory

Locations

607 Saint James Ave
Unit B
Goose Creek, SC 29445
Phone (843) 376-5595

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1346534781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 SAINT JAMES AVE",
            "address_2": "SUITE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452773",
            "telephone_number": "843-376-5595",
            "fax_number": "843-376-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 SAINT JAMES AVE",
            "address_2": "SUITE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452773",
            "telephone_number": "843-376-5595",
            "fax_number": "843-376-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSE CREEK PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "FRANZEN",
        "authorized_official_first_name": "JENS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-376-5595",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2773",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.