NPIMap

Organization Active NPI

Pivotal Injury and Rehab Inc

  • Multi-Specialty Clinic/Center
  • West Columbia, SC
National Provider Identifier
1386150613
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PIVOTAL INJURY AND REHAB INC
Practice address
103 Sum Mor Dr
West Columbia, SC 29169-4828
Phone
(803) 254-4699
Fax
(803) 851-1235
NPI assigned
Dec 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Ryan Wayne Bowers, DCNPI 1679899488
Title
Owner
Phone
(803) 254-4699

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

103 Sum Mor Dr
West Columbia, SC 29169-4828

Mailing address

PO Box 2632
Lexington, SC 29071-2632
Phone (803) 218-9886

Other names 1

  • Pivotal Health and Rehab Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drbowers@pivotalhealthandrehab.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180208002719 SC Part B Supplier - Clinic/Group Practice 0244590370 Receives reassigned benefits from 7 practitioners
Practice locations: West Columbia, SC
O20191102000375 SC DME Supplier - Physician - Physical and RehabilitationDME Supplier - Sports Medicine 0244590370 Practice locations: West Columbia, SC

National Provider Directory

National Provider Directory

Locations

2628 Millwood Ave
Ste C
Columbia, SC 29205

2627 Millwood Ave
Ste C
Columbia, SC 29205
Phone (803) 218-9886

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1386150613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2632",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290712632",
            "telephone_number": "803-218-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUM MOR DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694828",
            "telephone_number": "803-254-4699",
            "fax_number": "803-851-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIVOTAL INJURY AND REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-22",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-254-4699",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drbowers@pivotalhealthandrehab.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "103 Sum Mor Dr",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pivotal Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 6, 2023; 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.