Individual provider Active NPI

Laura Elaine Gerber, PT, DPT

  • Physical Therapist
  • Goose Creek, SC
National Provider Identifier
1366053258
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10251 Issued in SC
Practice address
104 Mallory Dr
Goose Creek, SC 29445-6406
Phone
(864) 275-0740
Fax
(843) 808-6986
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10251 SC Primary

Addresses

Primary practice location

104 Mallory Dr
Goose Creek, SC 29445-6406

Mailing address

PO Box 1119
Goose Creek, SC 29445-1119
Phone (864) 993-6304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908002497 SC Practitioner - Physical Therapist in Private Practice 8123446150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services of South Carolina, LLCGroup PAC ID 3971639998, 289 clinicians

Practice addresses (Care Compare)

800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10251SCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Centrum Therapy Services LLC Physical Therapist CurrentSince Mar 12, 2024 Accepting new patients

Organizations & group practices 2

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1366053258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294451119",
            "telephone_number": "864-993-6304",
            "fax_number": "843-808-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MALLORY DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294456406",
            "telephone_number": "864-275-0740",
            "fax_number": "843-808-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBER",
        "first_name": "LAURA",
        "middle_name": "ELAINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10251",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.