Individual provider Active NPI

Mary Ann Sims, PT

  • Physical Therapist
  • Goose Creek, SC
National Provider Identifier
1609396597
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8651 Issued in SC
Practice address
217A Saint James Ave
Goose Creek, SC 29445-2990
Phone
(843) 277-6232
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 8651 SC Primary

Addresses

Primary practice location

217A Saint James Ave
Goose Creek, SC 29445-2990

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other practice location 1

501 Forest Ln Ste A
Clemson, SC 29631-2621
Phone (864) 654-2001

Other identifiers 1

IdentifierTypeStateIssuer
8651OtherSCSC PT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170817002353 SC Practitioner - Physical Therapist in Private Practice 3577835040 Reassigns benefits to 3 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
Excel Rehabilitation and SportsGroup PAC ID 1759481559, 53 clinicians

Practice addresses (Care Compare)

501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone (864) 654-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8651SCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients
Private Therapy Services LLC Physical Therapist CurrentSince Feb 26, 2020 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

1941 Savage Rd
Ste 300A
Charleston, SC 29407
Phone (843) 402-1495

501 Forest Ln
Ste A
Clemson, SC 29631
Phone (864) 654-2001

1664 E Main St
Easley, SC 29640
Phone (864) 654-2001

217A Saint James Ave
Goose Creek, SC 29445
Phone (843) 277-6232

103 Halton Rd
#B
Greenville, SC 29607
Phone (864) 336-8599

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

11091 N Radio Station Rd
Seneca, SC 29678
Phone (864) 654-2001

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1609396597",
    "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",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217A SAINT JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452990",
            "telephone_number": "843-277-6232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Forest Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Clemson",
            "state": "SC",
            "postal_code": "296312621",
            "country_code": "US",
            "telephone_number": "864-654-2001",
            "fax_number": "800-305-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC PT LICENSE",
            "identifier": "8651",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.