Individual provider Active NPI

Daniel Ponton IV

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1467707273
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6561 Issued in SC
Practice address
109 Bee St
Charleston, SC 29401-5703
Phone
(843) 577-5011
NPI assigned
Jul 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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 6561 SC Primary

Addresses

Primary practice location

109 Bee St
Charleston, SC 29401-5703

Mailing address

1017 River Haven Cir Apt I
Charleston, SC 29412-4126

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
6561SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1467707273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 RIVER HAVEN CIR APT I",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTON",
        "first_name": "DANIEL",
        "name_suffix": "IV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.