Individual provider Active NPI

Mason H Rockwell, PT

  • Physical Therapist
  • Anderson, SC
National Provider Identifier
1487677274
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5456 Issued in SC
Practice address
1520 E Greenville St
Anderson, SC 29621-2056
Phone
(864) 261-3099
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 5456 SC Primary

Addresses

Primary practice location

1520 E Greenville St
Anderson, SC 29621-2056

Mailing address

790 Remington Blvd Ste a
Bolingbrook, IL 60440-4909
Phone (864) 722-0335

Other practice location 1

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019001166 SC Practitioner - Physical Therapist in Private Practice 9133268741 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
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)

8161 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 449-3685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5456SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Integrated Therapy Centers, LLC Physical Therapist CurrentSince Jun 19, 2020 Accepting new patients
Mountain State Physical Therapy LLC Past Accepting new patients

Locations

2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023

1007 Grove Rd
#A
Greenville, SC 29605

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1487677274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD STE A",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "864-722-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212056",
            "telephone_number": "864-261-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Remington Blvd",
            "address_purpose": "LOCATION",
            "city": "Bolingbrook",
            "state": "IL",
            "postal_code": "604404909",
            "country_code": "US",
            "telephone_number": "866-370-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "MASON",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.