Embodi, LLC.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

EMBODI, LLC.

Doing business as

Embodi Physical Therapy and Sports Performance

Practice address

420 Marvin Rd
Fort Mill, SC 29707-9670

Phone

(980) 254-1592

NPI assigned

Dec 3, 2021

Last updated

Dec 3, 2021By 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

Dr. Ronald W Weathers Jr., PT, DPT, SCS, ATCNPI 1528381779

Title

Founder / Ceo

Phone

(980) 254-1592

Specialties & licenses 1

Addresses

Other names 1

• Embodi Physical Therapy and Sports Performance Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronald W Weathers, PT

  • Physical Therapist
  • Charlotte, NC
  • NPI 1528381779
  NPD Authorized official

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1538827803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MARVIN RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297079670",
            "telephone_number": "980-254-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MARVIN RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297079670",
            "telephone_number": "980-254-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODI, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "WEATHERS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "FOUNDER / CEO",
        "authorized_official_telephone_number": "980-254-1592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT, DPT, SCS, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embodi Physical Therapy and Sports Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Physical Therapy Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.