Active NPI
Samantha A Crisafulli, DPT
- Physical Therapist
- Myrtle Beach, SC
National Provider Identifier
1528548948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9272
- Practice address
- 3076 Dick Pond Rd Unit 4
Myrtle Beach, SC 29588-7992 - Phone
- (843) 831-0163
- Fax
- (843) 831-0173
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9272 | SC | Primary |
Addresses
Primary practice location
3076 Dick Pond Rd Unit 4
Myrtle Beach, SC 29588-7992
Mailing address
PO Box 2397
Pawleys Island, SC 29585-2397
Phone (843) 235-0200
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9272 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1528548948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2397",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295852397",
"telephone_number": "843-235-0200",
"fax_number": "843-235-0242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3076 DICK POND RD UNIT 4",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887992",
"telephone_number": "843-831-0163",
"fax_number": "843-831-0173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISAFULLI",
"first_name": "SAMANTHA",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "9272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.