NPIMap

Organization Active NPI

Physical Rehabilitation Group

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1629407606
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL REHABILITATION GROUP
Practice address
113 Professional Park Rd
Columbia, SC 29229-7847
Phone
(803) 788-4705
Fax
(803) 788-4797
NPI assigned
Nov 11, 2013
Last updated
Dec 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PHYSICAL REHABILITATION GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
David Pegram, PTNPI 1013083690
Title
Owner
Phone
(803) 732-5887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X SC Primary

Addresses

Primary practice location

113 Professional Park Rd
Columbia, SC 29229-7847

Mailing address

PO Box 3408
Irmo, SC 29063-4015
Phone (803) 732-5887

National Provider Directory

National Provider Directory
Tax ID family
Physical Rehabilitation Group LLC4 organizations share this tax ID, including this one
Part of
Physical Rehabilitation Group LLC

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 76

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.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1629407606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3408",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290634015",
            "telephone_number": "803-732-5887",
            "fax_number": "803-732-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 PROFESSIONAL PARK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297847",
            "telephone_number": "803-788-4705",
            "fax_number": "803-788-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL REHABILITATION GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICAL REHABILITATION GROUP, LLC",
        "enumeration_date": "2013-11-11",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "PEGRAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-732-5887",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.