Individual provider Active NPI

Jessi Shirey, DPT, PT

  • Physical Therapist
  • Summerville, SC
National Provider Identifier
1598570467
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12739 Issued in SC
Practice address
440 Old Trolley Rd Ste D
Summerville, SC 29485-5685
Phone
(843) 871-3522
Fax
(843) 817-3523
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 12739 SC Primary

Addresses

Primary practice location

440 Old Trolley Rd Ste D
Summerville, SC 29485-5685

Mailing address

440 Old Trolley Rd Ste D
Summerville, SC 29485-5685
Phone (843) 871-3522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331003382 SC Practitioner - Physical Therapist in Private Practice 9335662337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Physical Therapy, LLCGroup PAC ID 1557452331, 4 clinicians

Practice addresses (Care Compare)

440 Old Trolley Rd D
Summerville, SC 29485-5685
Phone (843) 871-3522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12739SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Physical Therapy, LLC Physical Therapist CurrentSince Feb 13, 2025 Accepting new patients

Locations

440 Old Trolley Rd
Ste D
Summerville, SC 29485
Phone (843) 871-3522

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": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1598570467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 OLD TROLLEY RD STE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855685",
            "telephone_number": "843-871-3522",
            "fax_number": "843-817-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 OLD TROLLEY RD STE D",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855685",
            "telephone_number": "843-871-3522",
            "fax_number": "843-817-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIREY",
        "first_name": "JESSI",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.