Individual provider Active NPI

Sean M McEnroe, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1477559946
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4553 Issued in SC
Practice address
103 N Main St
Ste 99
Greenville, SC 29601-2796
Phone
(864) 528-5728
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 4553 SC Primary

Addresses

Primary practice location

103 N Main St
Ste 99
Greenville, SC 29601-2796

Mailing address

103 N Main St
Ste 300
Greenville, SC 29601-2796
Phone (864) 528-5700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4553SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy LLC Past Accepting new patients
Prisma Health University Medical Group Past Accepting new patients
Proaxis Spartanburg, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1477559946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "address_2": "STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012796",
            "telephone_number": "864-528-5700",
            "fax_number": "864-528-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "address_2": "STE 99",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012796",
            "telephone_number": "864-528-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENROE",
        "first_name": "SEAN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2013; 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.