Organization Active NPI

Rise Above Physical Therapy LLC

  • Physical Therapist
  • Summerville, SC
National Provider Identifier
1366062127
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RISE ABOVE PHYSICAL THERAPY LLC
Practice address
1655 Cane Bay Blvd Ste B
Summerville, SC 29486-2397
Phone
(843) 719-7473
Fax
(843) 279-3251
NPI assigned
Apr 22, 2020
Last updated
Sep 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Authorized official

Name
Stacy Rydbom, PTANPI 1467917617
Title
Dir of Operations
Phone
(724) 413-0297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1655 Cane Bay Blvd Ste B
Summerville, SC 29486-2397

Mailing address

1655 Cane Bay Blvd Ste B
Summerville, SC 29486-2397
Phone (843) 719-7473

Other practice location 1

3530 Park Avenue Blvd Ste 104
Mount Pleasant, SC 29466-7366
Phone (843) 491-4529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200527001182 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830510007 Receives reassigned benefits from 2 practitioners
Practice locations: Mount Pleasant, SC; Summerville, SC

National Provider Directory

National Provider Directory

Locations

431 Saint James Ave
Unit L212
Goose Creek, SC 29445

3530 Park Avenue Blvd
Ste 104
Mount Pleasant, SC 29466
Phone (843) 491-4529

1655 Cane Bay Blvd
#B
Summerville, SC 29486
Phone (843) 719-7473

Practitioners & affiliated clinicians

Practitioners 6

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": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1366062127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 CANE BAY BLVD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862397",
            "telephone_number": "843-719-7473",
            "fax_number": "843-279-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 CANE BAY BLVD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862397",
            "telephone_number": "843-719-7473",
            "fax_number": "843-279-3251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3530 Park Avenue Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294667366",
            "country_code": "US",
            "telephone_number": "843-491-4529",
            "fax_number": "843-279-3251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RISE ABOVE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "RYDBOM",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "DIR OF OPERATIONS",
        "authorized_official_telephone_number": "724-413-0297",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.