Laurel Delaney Black, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5675 Issued in SC

Practice address

216 Scuffletown Rd Ste B
Simpsonville, SC 29681-7296

Phone

(864) 254-5899

Fax

(864) 254-5898

NPI assigned

Feb 26, 2008

Last updated

Jan 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1588833362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SCUFFLETOWN RD STE B",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817296",
            "telephone_number": "864-254-5899",
            "fax_number": "864-254-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SCUFFLETOWN RD STE B",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817296",
            "telephone_number": "864-254-5899",
            "fax_number": "864-254-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LAUREL",
        "middle_name": "DELANEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Elliot Berke, M.A. CCC-A
• Benjamin Henry Bertino, LPC
• Sanjay Bhatt, DDS, MD
• Thomas David Bidwell, PHARMD
• Nivedita S Bijoor, MD
• Sonja Rena Black, RN
• Daniel Blackmon
• Connie J Blackstone, MD
• Marcus E Blackstone, MD
• Thomas Harold Blackwell, MD

• Physical Therapist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.