Organization Active NPI

Progressive Physical Therapy, PA

Doing business as Progressive Physical Therapy North Myrtle Beach

  • Physical Therapist
  • North Myrtle Beach, SC
National Provider Identifier
1619350568
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROGRESSIVE PHYSICAL THERAPY, PA
Doing business as
Progressive Physical Therapy North Myrtle Beach
Practice address
218 Highway 17 N
North Myrtle Beach, SC 29582-2938
Phone
(843) 491-2041
Fax
(843) 272-1344
NPI assigned
Jul 9, 2015
Last updated
Jul 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Barry E Fitch, DPTNPI 1568423887
Title
President
Phone
(803) 731-4055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

218 Highway 17 N
North Myrtle Beach, SC 29582-2938

Mailing address

1818 Henderson St
Columbia, SC 29201-2619
Phone (803) 758-2602

Other identifiers 1

IdentifierTypeStateIssuer
GP0231MedicaidSC

Other names 1

  • Progressive Physical Therapy North Myrtle Beach Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Progressive Physical Therapy PA19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1619350568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-758-2602",
            "fax_number": "803-253-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822938",
            "telephone_number": "843-491-2041",
            "fax_number": "843-272-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHYSICAL THERAPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "FITCH",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-731-4055",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0231",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Physical Therapy North Myrtle Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 9, 2015; 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.