Individual provider Active NPI

Tatiana Vasquez, DPT

  • Physical Therapist
  • Rock Hill, SC
National Provider Identifier
1497086094
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7818 Issued in SC
Practice address
700 Creekbridge Dr
Rock Hill, SC 29732-9169
Phone
(781) 608-9623
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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 008413 CT
Physical Therapist 225100000X 7818 SC Primary

Addresses

Primary practice location

700 Creekbridge Dr
Rock Hill, SC 29732-9169

Mailing address

700 Creekbridge Dr
Rock Hill, SC 29732-9169
Phone (781) 608-9623

Other practice location 1

728 Post Rd E
Westport, CT 06880-5200
Phone (203) 341-0488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7818SCMDPharmacist
008413CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mustard Seed Physical Therapy & Wellness, LLC Physical Therapist CurrentSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1497086094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CREEKBRIDGE DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329169",
            "telephone_number": "781-608-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CREEKBRIDGE DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329169",
            "telephone_number": "781-608-9623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 Post Rd E",
            "address_purpose": "LOCATION",
            "city": "Westport",
            "state": "CT",
            "postal_code": "068805200",
            "country_code": "US",
            "telephone_number": "203-341-0488",
            "fax_number": "203-227-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "TATIANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008413",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.