Individual provider Active NPI

Emma Diane McClendon, PTA

  • Physical Therapy Assistant
  • Hilton Head Island, SC
National Provider Identifier
1447904636
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4792 Issued in SC
Practice address
1012 William Hilton Pkwy Ste 7
Hilton Head Island, SC 29928-2703
Phone
(843) 715-4060
NPI assigned
Feb 7, 2022
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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 4792 SC Primary

Addresses

Primary practice location

1012 William Hilton Pkwy Ste 7
Hilton Head Island, SC 29928-2703

Mailing address

337 Worthington Cir
Spartanburg, SC 29303-6401
Phone (864) 202-1010

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

State licenses

LicenseStateTypeSpecialty
4792SCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1447904636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 WORTHINGTON CIR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293036401",
            "telephone_number": "864-202-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 WILLIAM HILTON PKWY STE 7",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299282703",
            "telephone_number": "843-715-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "EMMA",
        "middle_name": "DIANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.