Jaymi Mick

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2963 Issued in SC

Practice address

101 Brightwater Dr
Myrtle Beach, SC 29579-8275

Phone

(843) 655-0248

NPI assigned

Mar 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1629461595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BRIGHTWATER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295798275",
            "telephone_number": "843-655-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRIGHTWATER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295798275",
            "telephone_number": "843-655-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICK",
        "first_name": "JAYMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.