Individual provider Active NPI

John Maynard

  • Physical Therapist
  • Goose Creek, SC
National Provider Identifier
1578017877
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8277 Issued in SC
Practice address
209 Saint James Ave # B2
Goose Creek, SC 29445-2998
Phone
(843) 793-4466
NPI assigned
Aug 4, 2016
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 8277 SC Primary

Addresses

Primary practice location

209 Saint James Ave # B2
Goose Creek, SC 29445-2998

Mailing address

209 Saint James Ave Unit B2
Goose Creek, SC 29445-2998
Phone (843) 793-4466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003000590 SC Practitioner - Physical Therapist in Private Practice 5799072930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joints in Motion Physical Therapy and Wellness, LLCGroup PAC ID 1951588011, 5 clinicians

Practice addresses (Care Compare)

209 Saint James Ave
Suite 2B
Goose Creek, SC 29445-2998
Phone (843) 793-4466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8277SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Joints in Motion Physical Therapy and Wellness, LLC Physical Therapist CurrentSince May 1, 2011 Accepting new patients

Locations

209 Saint James Ave
Ste 2B
Goose Creek, SC 29445
Phone (843) 793-4466

214 Saint James Ave
Ste 140B
Goose Creek, SC 29445
Phone (843) 793-4466

Organizations & group practices 1

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1578017877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SAINT JAMES AVE UNIT B2",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452998",
            "telephone_number": "843-793-4466",
            "fax_number": "843-793-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SAINT JAMES AVE # B2",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452998",
            "telephone_number": "843-793-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.