NPIMap

Organization Active NPI

Matrix Rehabilitation -South Carolina Inc

Doing business as Vaughn, Buchanan, Shelley & Associates

  • Physical Therapy Clinic/Center
  • West Columbia, SC
National Provider Identifier
1487946109
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MATRIX REHABILITATION -SOUTH CAROLINA INC
Doing business as
Vaughn, Buchanan, Shelley & Associates
Practice address
3 Southern CT
Suite B
West Columbia, SC 29169-3060
Phone
(803) 403-8995
Fax
(803) 403-8996
NPI assigned
May 13, 2011
Last updated
May 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Authorized official

Name
Jayne Fleck Pool
Title
Chief Compliance Officer
Phone
(469) 467-8705

Specialties & licenses 1

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

Addresses

Primary practice location

3 Southern CT
Suite B
West Columbia, SC 29169-3060

Mailing address

PO Box 1245
Indiana, PA 15701-5245
Phone (724) 465-3496

Other names 1

  • Vaughn, Buchanan, Shelley & Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609000158 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5799694568 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Taylors, SC; Simpsonville, SC; Greenville, SC; Easley, SC

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1487946109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157015245",
            "telephone_number": "724-465-3496",
            "fax_number": "215-413-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SOUTHERN CT",
            "address_2": "SUITE B",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693060",
            "telephone_number": "803-403-8995",
            "fax_number": "803-403-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX REHABILITATION -SOUTH CAROLINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "FLECK",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-467-8705"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vaughn, Buchanan, Shelley & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.