Mandi Hamilton, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2438 Issued in SC

Practice address

2 Plaza Dr
Lugoff, SC 29078-9385

Phone

(803) 900-4020

Fax

(803) 753-9362

NPI assigned

Jun 6, 2016

Last updated

Jun 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

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.

• Lighthouse Therapeutics

  • Behavior Analyst
  • Lugoff, SC
  • NPI 1831646629
  NPD (past)

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1407205073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PLAZA DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789385",
            "telephone_number": "803-900-4020",
            "fax_number": "803-753-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PLAZA DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789385",
            "telephone_number": "803-900-4020",
            "fax_number": "803-753-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MANDI",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Circle Health LLC
• Susan Floyd Gregory, DMD
• Maria E Guilhamelou
• Rachel Kara Gunter-Garcia, LMSW
• James Levi Hall, LPCA
• Melissa Mongin Haney
• Felicia Denise Harris, FNP-BC
• Harry J. Koutroulakis D.M.D. Family Dentistry, P.a.
• Anna Watson Harvley, ATC
• Hawthorne Lugoff Pharmacy, LLC

• Physical Therapy Assistant in Lugoff, SC
• Providers in Lugoff, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.