Individual provider Active NPI

Emily Tum Suden, DPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1629638762
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11374 Issued in SC
Practice address
21 Gateway Corners Park Ste 102
Columbia, SC 29203-8906
Phone
(803) 699-9775
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11374 SC Primary
Physical Therapist 225100000X PT014011 GA
Physical Therapist 225100000X PT21377 NC

Addresses

Primary practice location

21 Gateway Corners Park Ste 102
Columbia, SC 29203-8906

Mailing address

21 Gateway Corners Park Ste 102
Columbia, SC 29203-8906
Phone (803) 699-9775

Other names 1

  • Emily Kiradjieff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230526001686 NC Practitioner - Physical Therapist in Private Practice 1850622549 Reassigns benefits to 1 organization
I20230615001686 SC Practitioner - Physical Therapist in Private Practice 1850622549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora South Carolina LLCGroup PAC ID 3173766334, 220 clinicians

Practice addresses (Care Compare)

851 Heckle Blvd
Rock Hill, SC 29730-2806
Phone (839) 388-0908

876 Fording Island Rd
Bluffton, SC 29910-8677
Phone (843) 507-8473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11374SCMDPharmacist
PT21377NCMDPhysical Therapist
PT11374SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy Associates LLC CurrentSince Dec 13, 2022 Accepting new patients
Carolina Physical Therapy Associates LLC Current Accepting new patients
Cora South Carolina LLC Current Accepting new patients
Cora South Carolina LLC CurrentSince Apr 19, 2023 Accepting new patients
Cora South Carolina LLC CurrentSince Apr 19, 2023 Accepting new patients
Carolina Physical Therapy Associates LLC CurrentSince Dec 13, 2022 Accepting new patients
First Physical Therapy LLC Past Accepting new patients
First Physical Therapy LLC Past Accepting new patients
First Physical Therapy, LLC Past Accepting new patients
First Physical Therapy LLC Past Accepting new patients
First Physical Therapy, LLC Past Accepting new patients
First Physical Therapy, LLC Past Accepting new patients
First Physical Therapy, LLC Past Accepting new patients
First Physical Therapy, LLC Past Accepting new patients
First Physical Therapy LLC Past Accepting new patients

Locations

401 Attain St
Ste 121
Fuquay Varina, NC 27526
Phone (252) 443-0808

271 Old Barn Rd
#C
Hendersonville, NC 28791
Phone (828) 890-4905

876 Fording Island Rd
Ste 2
Bluffton, SC 29910
Phone (843) 507-8473

851 Heckle Blvd
Ste 115
Rock Hill, SC 29730
Phone (839) 388-0908

515 Carnes Crossing Blvd
Ste B
Summerville, SC 29486
Phone (843) 507-8190

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1629638762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GATEWAY CORNERS PARK STE 102",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038906",
            "telephone_number": "803-699-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GATEWAY CORNERS PARK STE 102",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038906",
            "telephone_number": "803-699-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUM SUDEN",
        "first_name": "EMILY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT11374",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014011",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "PT21377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KIRADJIEFF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 1, 2022; 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.