Imagine Physical Therapy in West Ashley, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

IMAGINE PHYSICAL THERAPY IN WEST ASHLEY, LLC

Practice address

2267 Ashley River Road
Charleston, SC 29414-4736

Phone

(843) 576-4121

Fax

(843) 793-3575

NPI assigned

Jul 15, 2010

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beth Williamson

Title

Credentialing Specialist

Phone

(843) 804-9479

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Breland Green, PT, DPT

  • Physical Therapist
  • Summerville, SC
  • NPI 1457034811
  Medicare reassignment Care Compare group NPD
• Joseph Timothy Schriver, DPT

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1538683222
  Medicare reassignment Care Compare group NPD
• Jamie Lynn Kornegay

  • Physical Therapist
  • Charleston, SC
  • NPI 1881775286
  Medicare reassignment Care Compare group
• Macy N Alexander, DPT

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1215684121
  Medicare reassignment NPD
• Carl Gabriel Botero, PT, DPT

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1205564473
  Medicare reassignment NPD
• Aliece Wilson Christopher, PT

  • Physical Therapist
  • Daniel Island, SC
  • NPI 1598161259
  Medicare reassignment NPD
• Victoria Rose Conroy, DPT

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1730818923
  Medicare reassignment NPD
• Michael Andrew Gore, DPT

  • Physical Therapist
  • Greenville, SC
  • NPI 1629401914
  Medicare reassignment NPD
• Ryan Patrick Hill, DPT

  • Physical Therapist
  • Ladson, SC
  • NPI 1679860647
  Medicare reassignment NPD
• Wehme Carolyn Hutto

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1619416336
  Medicare reassignment NPD
• Brianna Hope Johnson, DPT

  • Physical Therapist
  • Charleston, SC
  • NPI 1073357117
  Medicare reassignment NPD
• John Mart

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1144255167
  Medicare reassignment NPD

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1588977862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 NORTH RHETT AVENUE",
            "address_2": "IMAGINE PHYSICAL THERAPY",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054219",
            "telephone_number": "843-804-9077",
            "fax_number": "843-804-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 ASHLEY RIVER ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294144736",
            "telephone_number": "843-576-4121",
            "fax_number": "843-793-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE PHYSICAL THERAPY IN WEST ASHLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "843-804-9479"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Kelly Ikert, CRNA
• Emily Ilderton
• Karen Abby Ilgen
• Romina Gil Ilic, M.D.
• Imagine Physical Therapy
• Imagine Physical Therapy on Daniel Island LLC
• Michelle Marie Imlay, PMHNP-BC
• In Home, LLC
• In Step LLC (Foot Solutions)
• George M Inabinet Jr., MD

• Physical Therapy Clinic/Center in Charleston, SC
• Providers in Charleston, SC by specialty
• Physical Therapy Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.