Individual provider Active NPI

Bonnie Allen Bottoms, P.T.A.

  • Physical Therapy Assistant
  • North Myrtle Beach, SC
National Provider Identifier
1598718280
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
577 Issued in SC
Practice address
543 Highway 17 N
North Myrtle Beach, SC 29582-2903
Phone
(843) 249-7232
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 577 SC Primary
Physical Therapy Assistant 225200000X 1773 NC

Addresses

Primary practice location

543 Highway 17 N
North Myrtle Beach, SC 29582-2903

Mailing address

543 Highway 17 N
North Myrtle Beach, SC 29582-2903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1773NCMDChiropractor
577SCMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1598718280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903",
            "telephone_number": "843-249-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTOMS",
        "first_name": "BONNIE",
        "middle_name": "ALLEN",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "577",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "1773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.