Thomas Vandiver

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12894 Issued in SC

Practice address

120 Mutual Dr
Anderson, SC 29621-1767

Phone

(864) 261-3313

Fax

(864) 261-3371

NPI assigned

Jun 10, 2025

Sex

Male

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

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Physical TherapyGroup PAC ID 0345275178, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Upstate Physical Therapy

  • Physical Therapist
  • Anderson, SC
  • NPI 1568410751

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Upstate Rehab Services

  • Rehabilitation Clinic/Center
  • Anderson, SC
  • NPI 1144815077
  NPD

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1629963707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MUTUAL DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211767",
            "telephone_number": "864-261-3313",
            "fax_number": "864-261-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MUTUAL DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211767",
            "telephone_number": "864-261-3313",
            "fax_number": "864-261-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliazar Valenzuela
• Rodolfo Jose Valverde Haeussler, MD
• Van C. Forrester, O.D. LLC (Forrester Eye Associates)
• Erin N. Van Duinen, PT, DPT
• Roger Scott Van Duinen, OTR
• Wynona Hope Vandiver, CPSS
• Jessica Shirldine Vanhannegeyn
• Julia Marie Varvatsis, PHARM.D.
• Crystal Vaughn, FNP
• Robert Vaughn, PA

• Physical Therapist in Anderson, SC
• Providers in Anderson, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.