Individual provider Active NPI

Melissa Ellen Rickenbaker, PT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1457688186
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2550 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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 2550 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Other practice location 1

301 E Dekalb St # B
Camden, SC 29020-4495
Phone (803) 432-2432

Other practice location 2

1514 Alexander Love Hwy E Ste 116
York, SC 29745-7770
Phone (803) 628-2220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000127 SC Practitioner - Physical Therapist in Private Practice 2365579620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2550SCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Jul 31, 2024 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Jul 31, 2024 Accepting new patients
Pro-Motion Physical Therapy of Camden, SC, LLC Physical Therapist CurrentSince Apr 25, 2021 Accepting new patients
Palmetto Rehabilitation Specialists, LLC Physical Therapist PastSince Oct 13, 2020 Accepting new patients
Ih3 Physcial Therapy Physical Therapist PastSince Oct 11, 2020 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA Past Accepting new patients

Locations

301 E DeKalb St
#B
Camden, SC 29020
Phone (803) 432-2432

720 Rabon Rd
Columbia, SC 29203
Phone (803) 462-0423

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

Interoperability endpoints

  • Direct secure messaging: melissa.rickenbaker.1@5499.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1457688186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Dekalb St # B",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "SC",
            "postal_code": "290204495",
            "country_code": "US",
            "telephone_number": "803-432-2432",
            "fax_number": "803-432-1779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1514 Alexander Love Hwy E Ste 116",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297457770",
            "country_code": "US",
            "telephone_number": "803-628-2220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKENBAKER",
        "first_name": "MELISSA",
        "middle_name": "ELLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "2550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.