NPIMap

Organization Active NPI

Palmetto Rehabilitation Specialists, LLC

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1508826025
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PALMETTO REHABILITATION SPECIALISTS, LLC
Practice address
105 Ben Casey Dr
Suite 127
Fort Mill, SC 29708-8561
Phone
(803) 802-5855
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Mr. Richard J Bates, PTNPI 1700993474
Title
Owner/Physical Therapist
Phone
(803) 802-5855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X SC Primary

Addresses

Primary practice location

105 Ben Casey Dr
Suite 127
Fort Mill, SC 29708-8561

Mailing address

105 Ben Casey Dr
Suite 127
Fort Mill, SC 29708-8561
Phone (803) 802-5855

Other practice location 1

1203 Colonial Commons Ct
Lancaster, SC 29720-2210
Phone (803) 286-0041

Other practice location 2

1514 Alexander Love Hwy E Ste 116
York, SC 29745-7770
Phone (803) 628-2220

Other practice location 3

1757 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 329-4685

Other identifiers 1

IdentifierTypeStateIssuer
GP4586MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060501000626 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1951311208 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Mill, SC; Lancaster, SC; Rock Hill, SC; York, SC

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Rehabilitation Specialists LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

6237 Carolina Commons Dr
Ste 305
Fort Mill, SC 29707

105 Ben Casey Dr
Fort Mill, SC 29708
Phone (803) 396-8670

105 Ben Casey Dr
Ste 127
Fort Mill, SC 29708
Phone (803) 448-3200

1203 Colonial Commons Ct
Lancaster, SC 29720
Phone (803) 286-0041

1514 Alexander Love Hwy E
Ste 116
York, SC 29745
Phone (803) 628-2220

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1508826025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR",
            "address_2": "SUITE 127",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088561",
            "telephone_number": "803-802-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR",
            "address_2": "SUITE 127",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088561",
            "telephone_number": "803-802-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Colonial Commons Ct",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "SC",
            "postal_code": "297202210",
            "country_code": "US",
            "telephone_number": "803-286-0041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1514 Alexander Love Hwy E Ste 116",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297457770",
            "country_code": "US",
            "telephone_number": "803-628-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1757 Ebenezer Rd",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321101",
            "country_code": "US",
            "telephone_number": "803-329-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PALMETTO REHABILITATION SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "803-802-5855",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4586",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.