Individual provider Active NPI

Lily Sara Waitsman, P.T

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1487053237
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7735 Issued in SC
Practice address
1400 W Georgia Rd Ste 400
Simpsonville, SC 29680-6970
Phone
(864) 757-3053
Fax
(864) 920-5122
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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 7735 SC Primary

Addresses

Primary practice location

1400 W Georgia Rd Ste 400
Simpsonville, SC 29680-6970

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

29 N Academy St
Greenville, SC 29601
Phone (864) 331-1364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805001874 SC Practitioner - Physical Therapist in Private Practice 2668919960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

1400 W Georgia Rd
Suite 400
Simpsonville, SC 29680-6970
Phone (864) 757-3053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15182NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy LLC CurrentSince Aug 19, 2024 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

29 N Academy St
Greenville, SC 29601
Phone (864) 331-1350

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

1400 W Georgia Rd
Ste 400
Simpsonville, SC 29680
Phone (864) 757-3053

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1487053237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W GEORGIA RD STE 400",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806970",
            "telephone_number": "864-757-3053",
            "fax_number": "864-920-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 N Academy St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "29601",
            "country_code": "US",
            "telephone_number": "864-331-1364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAITSMAN",
        "first_name": "LILY",
        "middle_name": "SARA",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7735",
            "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 Aug 10, 2026; 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.