Individual provider Active NPI

Kristina Danielle Manriquez

  • Physical Therapy Assistant
  • Simpsonville, SC
National Provider Identifier
1467943134
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3704 Issued in SC
Practice address
214 E Curtis St
Simpsonville, SC 29681-2622
Phone
(864) 384-9545
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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 3704 SC Primary

Addresses

Primary practice location

214 E Curtis St
Simpsonville, SC 29681-2622

Mailing address

102 Memory LN
Moore, SC 29369-9757

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

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1467943134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEMORY LN",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293699757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E CURTIS ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812622",
            "telephone_number": "864-384-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANRIQUEZ",
        "first_name": "KRISTINA",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.