Lawrence Edward Bertolucci, P.T. , M.A.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9962 Issued in OH

Practice address

38 Business Center Drive
Pawleys Island, SC 29585

Phone

(843) 235-0200

Fax

(843) 235-0242

NPI assigned

Jan 16, 2007

Last updated

Dec 7, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Professional Rehabilitation Services, Inc

  • Physical Therapy Clinic/Center
  • Pawley's Island, SC
  • NPI 1689622441

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1396896254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2397",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295852397",
            "telephone_number": "843-237-0200",
            "fax_number": "843-235-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 BUSINESS CENTER DRIVE",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "29585",
            "telephone_number": "843-235-0200",
            "fax_number": "843-235-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLUCCI",
        "first_name": "LAWRENCE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "P.T. , M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "9962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Pawley's Island, SC
• Providers in Pawley's Island, 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 Dec 7, 2009; 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.