Individual provider Active NPI

Samir Vaid, D.P.T

  • Physical Therapist
  • MC Cormick, SC
National Provider Identifier
1497042980
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6730 Issued in SC
Practice address
204 Holiday Rd
MC Cormick, SC 29835-3429
Phone
(706) 825-8059
NPI assigned
Jul 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT010338 GA
Physical Therapist 225100000X 6730 SC Primary

Addresses

Primary practice location

204 Holiday Rd
MC Cormick, SC 29835-3429

Mailing address

167 Durst Dr
North Augusta, SC 29860-8210
Phone (706) 825-8059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110816000161 GA Practitioner - Physical Therapist in Private Practice 6406025022 Reassigns benefits to 3 organizations
I20161216000512 SC Practitioner - Physical Therapist in Private Practice 6406025022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Rehabilitation and Wellness LLCGroup PAC ID 7517387095, 8 clinicians
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

2103 Reedale Ave
Augusta, GA 30906-3430
Phone (706) 814-6887

3335 Wise Creek LN
Aiken, SC 29801-2509
Phone (839) 868-9922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT010338GAMDPhysical Therapist
6730SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Rehabilitation & Wellness LLC Physical Therapist CurrentSince Aug 3, 2025 Accepting new patients
Advanced Pain Management, P.C. CurrentSince Sep 7, 2024 Accepting new patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Jul 21, 2023 Accepting new patients
Proactive Physical Therapy and Rehabilitation LLC Physical Therapist CurrentSince Aug 3, 2025 Accepting new patients
Evans Procedure Center, LLC Past Accepting new patients

Locations

2103 Reedale Ave
Augusta, GA 30906
Phone (706) 414-5058

404 Town Park Blvd
Ste 101
Evans, GA 30809
Phone (706) 364-5065

2450 Buford Dr
Lawrenceville, GA 30043
Phone (470) 712-5883

7300 Spalding Dr
Peachtree Corners, GA 30092
Phone (404) 436-2202

Organizations & group practices 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1497042980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 DURST DR",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298608210",
            "telephone_number": "706-825-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HOLIDAY RD",
            "city": "MC CORMICK",
            "state": "SC",
            "postal_code": "298353429",
            "telephone_number": "706-825-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAID",
        "first_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010338",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Cormick, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.