NPIMap

Organization Active NPI

South Aiken Physical Therapy, LLC

  • Physical Therapist
  • Aiken, SC
National Provider Identifier
1558653196
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7668 Issued in SC
Legal business name
SOUTH AIKEN PHYSICAL THERAPY, LLC
Practice address
943 Pine Log Rd
Aiken, SC 29803
Phone
(803) 649-9797
Fax
(803) 642-2759
NPI assigned
May 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Susan Sturgill
Title
Office Manager
Phone
(803) 649-9797

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 7668 SC Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

943 Pine Log Rd
Aiken, SC 29803

Mailing address

943 Pine Log Rd
Aiken, SC 29803-7330
Phone (803) 649-9797

Other names 1

  • South Aiken Physical Therapy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110930000622 SC Part B Supplier - Clinic/Group Practice 3678745320 Receives reassigned benefits from 15 practitioners
Practice locations: Aiken, SC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

249 Fabian Dr
Aiken, SC 29803
Phone (803) 649-9797

681 Silver Bluff Rd
Ste A
Aiken, SC 29803
Phone (803) 649-9797

943 Pine Log Rd
Aiken, SC 29803
Phone (803) 648-2366

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1558653196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 PINE LOG RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037330",
            "telephone_number": "803-649-9797",
            "fax_number": "803-642-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 PINE LOG RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29803",
            "telephone_number": "803-649-9797",
            "fax_number": "803-642-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH AIKEN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "STURGILL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-649-9797"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7668",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Aiken Physical Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "South Aiken Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.