Pruitthealth Therapy Services, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

PRUITTHEALTH THERAPY SERVICES, INC.

Practice address

1020 N Congress St
York, SC 29745-1351

Phone

(803) 684-0183

NPI assigned

May 24, 2017

Last updated

May 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Neil L Pruitt Jr.

Title

Chairman and Ceo

Phone

(770) 279-6200

Specialties & licenses 1

Addresses

Other names 1

• PruittHealth Therapy Services - York Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538697313. Details of each certification follow.

• CCN 426652 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 426652

Legal name

PRUITTHEALTH THERAPY SERVICES, INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Oct 26, 2018

Last certification

Aug 2, 2023

Ownership / control type

Proprietary

Facility address

1020 North Congress Street
York, SC 29745

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1538697313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N CONGRESS ST",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297451351",
            "telephone_number": "803-684-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Therapy Services - York",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ethan Powell, PTA
• Kenya Powell
• Premier Clinics of York (Premier Clinics)
• Priester Nichols Health Services, LLC
• Raynette Mashonda Priester
• Timothy Puckett, DC
• Michael Lance Queen, MD
• Daniela Quiroz
• Rachel Fite, LLC
• Christian Juan Ramos

• Rehabilitation Clinic/Center in York, SC
• Providers in York, SC by specialty
• Rehabilitation Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.