Individual provider Active NPI

Ebony Nicole Therrier, DPT

  • Physical Therapist
  • Easton, PA
National Provider Identifier
1558649335
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH5706 Issued in AL
Practice address
2222 Sullivan TRL
Easton, PA 18040-7958
Phone
(800) 944-9782
NPI assigned
Jul 28, 2011
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P19788 NC
Physical Therapist 225100000X PT8590 SC
Physical Therapist 225100000X PTH5706 AL Primary

Addresses

Primary practice location

2222 Sullivan TRL
Easton, PA 18040-7958

Mailing address

385 S Revere CV Apt 108
Tega Cay, SC 29708-8696
Phone (706) 267-8577

Other identifiers 2

IdentifierTypeStateIssuer
PTH 5706OtherALPROFESSIONAL LICENSE
058494112OtherGADRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210618001475 SC Practitioner - Physical Therapist in Private Practice 7315118015 Reassigns benefits to 1 organization
I20260113002765 NC Practitioner - Physical Therapist in Private Practice 7315118015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

11945 Providence Rd
Charlotte, NC 28277-4454
Phone (980) 245-2676

7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333

980 Chestnut LN
Matthews, NC 28104-8543
Phone (980) 585-9293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P19788NCMDPhysical Therapist
PT8590SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group Inc. Physical Therapist CurrentSince Dec 1, 2025 Accepting new patients
The Weston Group Inc Physical Therapist CurrentSince Dec 1, 2025 Accepting new patients
Champion Rehab Resources, LLC Physical Therapist PastSince Mar 25, 2026 Accepting new patients

Locations

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

Organizations & group practices 4

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1558649335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 S REVERE CV APT 108",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297088696",
            "telephone_number": "706-267-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "800-944-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERRIER",
        "first_name": "EBONY",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19788",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT8590",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH5706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PTH 5706",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "058494112",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.