Individual provider Active NPI

Jaislie Olivia Bernard, PTA

  • Physical Therapy Assistant
  • Summerville, SC
National Provider Identifier
1417753344
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
440 Old Trolley Rd Ste D
Summerville, SC 29485-5685
Phone
(843) 871-3522
Fax
(843) 871-3523
NPI assigned
Feb 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

440 Old Trolley Rd Ste D
Summerville, SC 29485-5685

Mailing address

440 Old Trolley Rd Ste D
Summerville, SC 29485-5685
Phone (843) 871-3522

Other names 1

  • Jaislie Sheaffer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Physical Therapy, LLC CurrentSince Feb 23, 2025 Accepting new patients

Locations

440 Old Trolley Rd
Ste D
Summerville, SC 29485
Phone (843) 871-3522

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1417753344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 OLD TROLLEY RD STE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855685",
            "telephone_number": "843-871-3522",
            "fax_number": "843-871-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 OLD TROLLEY RD STE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855685",
            "telephone_number": "843-871-3522",
            "fax_number": "843-871-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "JAISLIE",
        "middle_name": "OLIVIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAISLIE",
            "last_name": "SHEAFFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.