Elevate Physical Medicine LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ELEVATE PHYSICAL MEDICINE LLC

Practice address

700 Squires PT Ste B
Duncan, SC 29334-8879

Phone

(864) 607-4327

Fax

(864) 752-1653

NPI assigned

May 15, 2020

Organization subpart

No

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

Authorized official

Name

Matthew Wink

Title

Owner

Phone

(864) 607-4327

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1346862018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SQUIRES PT STE B",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348879",
            "telephone_number": "864-607-4327",
            "fax_number": "864-752-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SQUIRES PT STE B",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348879",
            "telephone_number": "864-607-4327",
            "fax_number": "864-752-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "WINK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-607-4327"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destination Dental of Duncan LLC
• Jennifer D Dewyea, PT
• Derek T Dunlap, DMD
• Gabrielle Eberle, M.S. CCC-SLP
• Jennifer Marie Echenagucia, MA CCC/SLP
• Emory Upper Cervical Chiropractic Dba Wellness Chiropractic Health Cen
• Tammy Caroline Emory, D.C.
• Nicole Filian, MSW, LCSW, LISW-CP
• First Physical Therapy LLC
• Beth Ellen Fiszer, MSN, APRN, FNP-C

• Multi-Specialty Clinic/Center in Duncan, SC
• Providers in Duncan, SC by specialty
• Multi-Specialty Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.