Individual provider Active NPI

Courtney Staudt, DPT

  • Physical Therapist
  • Lexington, SC
National Provider Identifier
1568268779
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12740 Issued in SC
Practice address
109 Park Place CT
Lexington, SC 29072-6690
Phone
(803) 256-4107
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12740 SC Primary

Addresses

Primary practice location

109 Park Place CT
Lexington, SC 29072-6690

Mailing address

1001 True St Apt 516
Columbia, SC 29209-1749

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324000845 SC Practitioner - Physical Therapist in Private Practice 2264954874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midlands Orthopaedics and Neurosurgery PAGroup PAC ID 8628963287, 41 clinicians

Practice addresses (Care Compare)

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12740SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Jan 5, 2025 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Jan 5, 2025 Accepting new patients

Locations

1930 Blanding St
Columbia, SC 29201
Phone (803) 461-4740

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

109 Park Place Ct
Lexington, SC 29072
Phone (803) 933-6784

Interoperability endpoints

  • Direct secure messaging: courtney.staudt.1@5499.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1568268779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 TRUE ST APT 516",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PARK PLACE CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726690",
            "telephone_number": "803-256-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDT",
        "first_name": "COURTNEY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.