Individual provider Active NPI

Avery Conner Epstein, PT, DPT

  • Physical Therapist
  • Spartanburg, SC
National Provider Identifier
1376309468
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12447 Issued in SC
Practice address
333 S Pine St
Spartanburg, SC 29302-2622
Phone
(864) 515-7580
NPI assigned
Feb 26, 2024
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 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
Physical Therapist 225100000X 40QA02237300 NJ
Physical Therapist 225100000X 12447 SC Primary

Addresses

Primary practice location

333 S Pine St
Spartanburg, SC 29302-2622

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

1261 Route 9 S
Cape May Court House, NJ 08210-2761
Phone (609) 465-8801

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240402000168 NJ Practitioner - Physical Therapist in Private Practice 7517305188 Reassigns benefits to 2 organizations
I20240906000222 SC Practitioner - Physical Therapist in Private Practice 7517305188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

333 S Pine St
Spartanburg, SC 29302-2622
Phone (864) 515-7580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Ipta Clinical, LLC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Mar 4, 2024 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Aug 26, 2024 Accepting new patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist PastSince Feb 23, 2025 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

1261 Route 9 S
Cape May Court House, NJ 08210
Phone (609) 465-3866

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

1572 Route 206
Ste 4
Tabernacle, NJ 08088
Phone (609) 257-3750

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

200 Patewood Dr
Ste C150
Greenville, SC 29615
Phone (864) 454-0904

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

727 SE Main St
Ste 200
Simpsonville, SC 29681
Phone (864) 454-6670

333 S Pine St
Spartanburg, SC 29302
Phone (864) 515-7500

2660 Reidville Rd
Ste 6
Spartanburg, SC 29301
Phone (864) 576-3738

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1376309468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022622",
            "telephone_number": "864-515-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1261 Route 9 S",
            "address_purpose": "LOCATION",
            "city": "Cape May Court House",
            "state": "NJ",
            "postal_code": "082102761",
            "country_code": "US",
            "telephone_number": "609-465-8801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "AVERY",
        "middle_name": "CONNER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02237300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.