Moncks Corner Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

767 Issued in SC

Legal business name

MONCKS CORNER PHYSICAL THERAPY, LLC

Practice address

209 W Main St
Moncks Corner, SC 29461-2604

Phone

(843) 899-5374

Fax

(843) 899-5376

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Frances P. Johnson

Title

Co-Owner/Physical Therapist

Phone

(843) 899-5374

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodney N. Tyler Jr., OTR/L, CHT

  • Occupational Therapist
  • Moncks Corner, SC
  • NPI 1568473296
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1366453003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612604",
            "telephone_number": "843-899-5374",
            "fax_number": "843-899-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612604",
            "telephone_number": "843-899-5374",
            "fax_number": "843-899-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONCKS CORNER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CO-OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "843-899-5374"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "767",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1202",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Mitchum
• Lauren Mitchum
• Moncks Corner Dental Group, PC
• Moncks Corner Pediatrics LLC
• Moncks Corner Pediatrics LLC
• Laquawn J Montgomery
• Joseph Carlisle Moore Jr., M.D.
• Kathleen Bailey Moore, RN, BSN
• Sandy Moore, RN
• Ashlyn Morrison

• Physical Therapist in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.