Individual provider Active NPI

Dillian Wayne McDonald, DPT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1518633031
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12693 Issued in SC
Practice address
11 Barkingham LN Ste C
Greenville, SC 29607-5905
Phone
(864) 881-1712
NPI assigned
Aug 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 12693 SC Primary
Physical Therapist 225100000X LPT-31973 AZ

Addresses

Primary practice location

11 Barkingham LN Ste C
Greenville, SC 29607-5905

Mailing address

11 Barkingham LN Ste C
Greenville, SC 29607-5905
Phone (864) 881-1712

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211001002670 AZ Practitioner - Physical Therapist in Private Practice 9537567789 Reassigns benefits to 2 organizations
I20250227002005 SC Practitioner - Physical Therapist in Private Practice 9537567789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Purposed Physical Therapy, LLC.Group PAC ID 7911233457, 5 clinicians

Practice addresses (Care Compare)

11 Barkingham LN
Suite C
Greenville, SC 29607-5905
Phone (864) 881-1712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31973AZMDPhysical Therapist
12693SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Purposed Physical Therapy, LLC. CurrentSince Feb 4, 2025 Accepting new patients
Petkov Bodywork Therapy, LLC CurrentSince Sep 6, 2022 Accepting new patients
Allone Healthcare LLC CurrentSince Oct 27, 2024 Accepting new patients
360 Physical Therapy LLC CurrentSince Aug 25, 2021 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Aug 25, 2021 Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

4210 E Baseline Rd
Ste 106
Mesa, AZ 85206
Phone (480) 503-2373

11 Barkingham Ln
#C
Greenville, SC 29607
Phone (864) 881-1712

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1518633031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BARKINGHAM LN STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075905",
            "telephone_number": "864-881-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BARKINGHAM LN STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075905",
            "telephone_number": "864-881-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DILLIAN",
        "middle_name": "WAYNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12693",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.