Individual provider Active NPI

Michelle Loraine Holcombe, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1457411852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5342 Issued in SC
Practice address
319 Mills Ave
Greenville, SC 29605-4021
Phone
(864) 233-1153
Fax
(864) 271-4487
NPI assigned
Dec 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5342 SC Primary

Addresses

Primary practice location

319 Mills Ave
Greenville, SC 29605-4021

Mailing address

47 Huntress Dr
Greer, SC 29651-1284
Phone (864) 363-3090

Other names 1

  • Miss Michelle Loraine Moore Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120912000608 SC Practitioner - Physical Therapist in Private Practice 4385892546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

190 River Park Dr
Little River, SC 29566-6844
Phone (843) 734-1457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5342SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Matrix Rehabilitation South Carolina, Inc. Past Accepting new patients
Matrix Rehabilitation-South Carolina, Inc. Physical Therapist Past Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

1180 Haywood Rd
Greenville, SC 29615
Phone (864) 288-8093

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457411852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 HUNTRESS DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511284",
            "telephone_number": "864-363-3090",
            "fax_number": "864-271-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054021",
            "telephone_number": "864-233-1153",
            "fax_number": "864-271-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMBE",
        "first_name": "MICHELLE",
        "middle_name": "LORAINE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MOORE",
            "middle_name": "LORAINE",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.