Organization Active NPI

Columbia Rehabilitation Clinic

  • Physical Medicine & Rehabilitation Physician
  • West Columbia, SC
National Provider Identifier
1457448144
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
COLUMBIA REHABILITATION CLINIC
Practice address
1177 Sunset Blvd
West Columbia, SC 29169-6863
Phone
(803) 794-3440
Fax
(803) 791-3862
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Authorized official

Name
Mr. Bruce David FillerNPI 1043307614
Title
Owner
Phone
(803) 799-7007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1177 Sunset Blvd
West Columbia, SC 29169-6863

Mailing address

1177 Sunset Blvd
Columbia Rehabilitation Clinic
West Columbia, SC 29169-6863
Phone (803) 794-3440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090928000499 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668431644 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blythewood, SC; Columbia, SC; West Columbia, SC

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Columbia Rehabilitation Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1177 Sunset Blvd
West Columbia, SC 29169
Phone (803) 794-3440

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1457448144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 SUNSET BLVD",
            "address_2": "COLUMBIA REHABILITATION CLINIC",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291696863",
            "telephone_number": "803-794-3440",
            "fax_number": "803-791-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291696863",
            "telephone_number": "803-794-3440",
            "fax_number": "803-791-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA REHABILITATION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "FILLER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-799-7007",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.