Individual provider Active NPI

C'Asia Bermudez, PT, DPT

  • Physical Therapist
  • West Columbia, SC
National Provider Identifier
1356946495
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12639 Issued in SC
Practice address
125 State St Ste 3
West Columbia, SC 29169-7557
Phone
(803) 973-0808
NPI assigned
Dec 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 P22630 NC
Physical Therapist 225100000X PT014998 GA
Physical Therapist 225100000X PT12639 SC Primary

Addresses

Primary practice location

125 State St Ste 3
West Columbia, SC 29169-7557

Mailing address

125 State St Ste 3
West Columbia, SC 29169-7557

Other practice location 1

5232 Sunset Blvd Ste B
Lexington, SC 29072-9347
Phone (803) 756-4744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240320001290 NC Practitioner - Physical Therapist in Private Practice 3678910106 Reassigns benefits to 2 organizations
I20250225000668 SC Practitioner - Physical Therapist in Private Practice 3678910106 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12639SCMDSocial Worker
PT014998GAMDPhysical Therapist
P22630NCMDPhysical Therapist
PT12639SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Sep 15, 2023 Accepting new patients
Proactive Therapy of North Carolina Inc CurrentSince Sep 15, 2023 Accepting new patients
Proactive Therapy of North Carolina Inc Current Accepting new patients
Select Physical Therapy Holdings Inc Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Feb 10, 2025 Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Sep 15, 2023 Accepting new patients
Select Physical Therapy Holdings, Inc. Physical Therapist Current Accepting new patients

Locations

60 Livingston St
Ste 400
Asheville, NC 28801
Phone (828) 258-0797

3611 Mt Holly Huntersville Rd
Ste 204
Charlotte, NC 28216
Phone (980) 256-3171

10020 Edison Square Dr NW
Ste C105
Concord, NC 28027
Phone (704) 948-5351

1630 Campus Park Dr
Ste D
Monroe, NC 28112
Phone (704) 283-9422

2358 US Highway 70
Ste Ab
Swannanoa, NC 28778
Phone (828) 686-3375

4600 Forest Dr
Ste 2
Columbia, SC 29206
Phone (803) 376-9789

870 Gold Hill Rd
Ste 103
Fort Mill, SC 29708
Phone (803) 835-6000

5232 Sunset Blvd
Ste B
Lexington, SC 29072
Phone (803) 756-4744

125 State St
Ste 3
West Columbia, SC 29169
Phone (803) 756-4744

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1356946495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 STATE ST STE 3",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291697557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 STATE ST STE 3",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291697557",
            "telephone_number": "803-973-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5232 Sunset Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290729347",
            "country_code": "US",
            "telephone_number": "803-756-4744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "C'ASIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22630",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014998",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT12639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.