Active NPI
Renee Georgette Gobeille
- Physical Therapy Assistant
- Little River, SC
National Provider Identifier
1609598119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4975
- Practice address
- 190 River Park Dr
Little River, SC 29566-6844 - Phone
- (843) 741-0082
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4975 | SC | Primary |
Addresses
Primary practice location
190 River Park Dr
Little River, SC 29566-6844
Mailing address
100 Horizon Dr
Suite 310
Raleigh, NC 27615
Phone (919) 424-5080
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4975 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1609598119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HORIZON DR",
"address_2": "SUITE 310",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27615",
"telephone_number": "919-424-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 RIVER PARK DR",
"city": "LITTLE RIVER",
"state": "SC",
"postal_code": "295666844",
"telephone_number": "843-741-0082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOBEILLE",
"first_name": "RENEE",
"middle_name": "GEORGETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "4975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little River, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.