Active NPI
Jennifer Rose Hause, MPT, CIMT
- Physical Therapist
- Indian Land, SC
National Provider Identifier
1447334685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7440
- Practice address
- 7580 Charlotte Hwy
Suite 1100
Indian Land, SC 29707-7801 - Phone
- (803) 578-5662
- Fax
- (803) 548-5635
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7440 | NC | Primary |
Addresses
Primary practice location
7580 Charlotte Hwy
Suite 1100
Indian Land, SC 29707-7801
Mailing address
7580 Charlotte Hwy
Suite 1100
Indian Land, SC 29707-7801
Phone (803) 578-5662
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7440 | Other | NC | STATE LICENSE |
| 079KX | Other | NC | BCBS PROVIDER |
| 7211645 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7440 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activcare Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
| Carolina Complete Rehab Center of Hope Mills Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Pivot Physical Therapy of Carolina
- Clinic/Center
- Raleigh, NC
- NPI 1548409626
Physical Therapist
-
- Physical Therapist
- Hope Mills, NC
- NPI 1144270372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429747200000",
"number": "1447334685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7580 CHARLOTTE HWY",
"address_2": "SUITE 1100",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297077801",
"telephone_number": "803-578-5662",
"fax_number": "803-548-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7580 CHARLOTTE HWY",
"address_2": "SUITE 1100",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297077801",
"telephone_number": "803-578-5662",
"fax_number": "803-548-5635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUSE",
"first_name": "JENNIFER",
"middle_name": "ROSE",
"credential": "MPT, CIMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2015-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "7440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "7440",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER",
"identifier": "079KX",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211645",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indian Land, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.