Active NPI
Christopher Thomas Penuel, PTA
- Physical Therapy Assistant
- Greenville, SC
National Provider Identifier
1477721983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2209
- Practice address
- 355 Berkmans LN
Greenville, SC 29605-5606 - Phone
- (864) 235-9020
- Fax
- (864) 235-9021
- NPI assigned
- Feb 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2209 | SC | Primary |
Addresses
Primary practice location
355 Berkmans LN
Greenville, SC 29605-5606
Mailing address
10 Paris Rd
Taylors, SC 29687-6958
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2209 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1477721983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PARIS RD",
"city": "TAYLORS",
"state": "SC",
"postal_code": "296876958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BERKMANS LN",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296055606",
"telephone_number": "864-235-9020",
"fax_number": "864-235-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENUEL",
"first_name": "CHRISTOPHER",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-19",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "2209",
"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 Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.