NPIMap

Organization Active NPI

Five Star Rehabilitation and Wellness Services, LLC.

  • Physical Therapy Clinic/Center
  • Mt Pleasant, SC
National Provider Identifier
1487940334
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.
Practice address
937 Bowman Rd
Mt Pleasant, SC 29464-3336
Phone
(843) 388-2030
Fax
(843) 971-5487
NPI assigned
Jun 20, 2011
Organization subpart
Yes
Parent organization
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey C Leer
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

937 Bowman Rd
Mt Pleasant, SC 29464-3336

Mailing address

255 Washington St Ste 230
Newton, MA 02458-1644
Phone (617) 796-8350

Other practice location 1

601 Mathis Ferry Rd
MT Pleasant, SC 29464-7620
Phone (843) 881-9809 ext. 122

Other names 1

  • Ageility Physical Therapy Solutions at Mount Pleasant Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120501000834 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0143323535 Practice locations: Mount Pleasant, SC

Outpatient physical therapy / speech pathology certification: CCN 426637

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
AGEILITY PHYSICAL THERAPY SOLUTIONS MOUNT PLEASAN
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jan 2, 2013
Last certification
Jan 24, 2023
Ownership / control type
Proprietary
Facility address
937 Bowman Rd
Mount Pleasant, SC 29464

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Five Star Rehab7 organizations share this tax ID, including this one
Part of
Five Star Rehab

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1487940334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 230",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581644",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 BOWMAN RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643336",
            "telephone_number": "843-388-2030",
            "fax_number": "843-971-5487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Mathis Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "SC",
            "postal_code": "294647620",
            "country_code": "US",
            "telephone_number": "843-881-9809 x122",
            "fax_number": "843-881-0693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at Mount Pleasant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.