NPIMap

TX: Team Rehab Inc.

Organization Active NPI Physical Therapist · Mt Pleasant, SC

NPI 1396795142 · NPPES record last updated Jun 12, 2019

Key facts

NPI
1396795142
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
1904 (SC)
Legal business name
TX: TEAM REHAB INC.
Practice address
3100 Tradition Cir
Mt Pleasant, SC 29466-7200
Phone
(843) 694-7945
Fax
(843) 884-6481
NPI assigned
May 11, 2006
Organization subpart
No

Authorized official

Name
Mr. Scott S Benedict
Title
Ceo
Phone
(317) 884-3383

Practitioners 48

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

View all 48

Medicare participation

Medicare fee-for-service enrollment
Enrolled (4 enrollments) in SC, GA, AL, TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031216000134 SC Part B Supplier - Clinic/Group Practice 1759288087 Receives reassigned benefits from 7 practitioners
Practice locations: Mount Pleasant, SC
O20160331000728 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759288087 Receives reassigned benefits from 7 practitioners
Practice locations: Peachtree City, GA; Sandy Springs, GA
O20170331001295 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759288087 Receives reassigned benefits from 16 practitioners
Practice locations: Mobile, AL; Tuscaloosa, AL; Hoover, AL; Huntsville, AL; Auburn, AL; Fairhope, AL
O20190319000207 TN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759288087 Receives reassigned benefits from 5 practitioners
Practice locations: Franklin, TN

National Provider Directory

Locations

8777 Purdue Rd
Ste 330
Indianapolis, IN 46268

11240 Ballantyne Trace Ct
Charlotte, NC 28277
Phone (704) 277-3276

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X 1904 SC Yes
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X 5729 SC
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X 7188 SC
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X 3701 SC
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X 1116 SC
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X 2603 SC
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X 3936 SC
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X 4296 SC
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X 4833 SC
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X 5475 SC

Addresses

Primary practice location

3100 Tradition Cir
Mt Pleasant, SC 29466-7200

Mailing address

9101 Wesleyan Rd Ste 100
Indianapolis, IN 46268-3103
Phone (800) 603-6046

Other identifiers

IdentifierTypeStateIssuer
GP6089MedicaidSC

Other names

  • Tx:Team Rehab Inc. Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2019.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1396795142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 WESLEYAN RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683103",
            "telephone_number": "800-603-6046",
            "fax_number": "317-884-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TRADITION CIR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667200",
            "telephone_number": "843-694-7945",
            "fax_number": "843-884-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TX: TEAM REHAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "BENEDICT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-884-3383",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1904",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5729",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7188",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3701",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "1116",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2603",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3936",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4296",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4833",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6089",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tx:Team Rehab Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Tx:Team Rehab Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mt Pleasant, SC

All providers in Mt Pleasant, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.