Individual provider Active NPI

Cody Gordon Gunselman, DPT

  • Physical Therapist
  • North Charleston, SC
National Provider Identifier
1609336213
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9576 Issued in SC
Practice address
9241 University Blvd Ste a
North Charleston, SC 29406-9349
Phone
(843) 764-4887
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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 9576 SC Primary

Addresses

Primary practice location

9241 University Blvd Ste a
North Charleston, SC 29406-9349

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190501002143 SC Practitioner - Physical Therapist in Private Practice 9830431451 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Private Therapy Services LLCGroup PAC ID 7810978616, 16 clinicians

Practice addresses (Care Compare)

445 Savannah Hwy
Charleston, SC 29407-7207
Phone (843) 766-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Mar 5, 2019 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Mar 5, 2019 Accepting new patients
Private Therapy Services LLC Physical Therapist CurrentSince Feb 4, 2020 Accepting new patients
The PT Blueprint, LLC Physical Therapist CurrentSince Mar 20, 2026 Accepting new patients
Coastal Movement Specialists LLC Physical Therapist CurrentSince Oct 17, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33299 Collection Ctr Dr
Chicago, IL 60693

445 Savannah Hwy
Charleston, SC 29407
Phone (843) 766-2121

2052 River Rd
Ste E
Johns Island, SC 29455
Phone (843) 900-6202

9241 University Blvd
Ste A
North Charleston, SC 29406
Phone (843) 414-1140

5660 Rivers Ave
Ste B
North Charleston, SC 29406
Phone (440) 225-1425

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1609336213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 UNIVERSITY BLVD STE A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069349",
            "telephone_number": "843-764-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNSELMAN",
        "first_name": "CODY",
        "middle_name": "GORDON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.