NPIMap

Organization Active NPI

Matrix Rehabilitation South Carolina, Inc.

  • Rehabilitation Clinic/Center
  • Greenville, SC
National Provider Identifier
1427463306
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
MATRIX REHABILITATION SOUTH CAROLINA, INC.
Practice address
138 Milestone Way
Suite a
Greenville, SC 29615-6618
Phone
(864) 288-2249
Fax
(864) 329-8563
NPI assigned
Jun 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Authorized official

Name
Mr. Michael E Tarvin
Title
Vice President and Secretary
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

138 Milestone Way
Suite a
Greenville, SC 29615-6618

Mailing address

4714 Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Vaughn, Buchanan, Shelley & Associates-Milestone Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609000158 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5799694568 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Taylors, SC; Simpsonville, SC; Greenville, SC; Easley, SC

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

138 Milestone Way
Ste A
Greenville, SC 29615
Phone (864) 236-1630

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1427463306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MILESTONE WAY",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156618",
            "telephone_number": "864-288-2249",
            "fax_number": "864-329-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX REHABILITATION SOUTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vaughn, Buchanan, Shelley & Associates-Milestone",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vaughn, Buchanan, Shelley & Associates-Milestone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.