Individual provider Active NPI

Steven R. Tilley, MPT

  • Physical Therapist
  • Seneca, SC
National Provider Identifier
1639309859
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10879 Clemson Blvd
Seneca, SC 29678-1303
Phone
(864) 482-0085
Fax
(864) 482-0072
NPI assigned
Jul 22, 2009
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2816 NC
Physical Therapist 225100000X SC Primary

Addresses

Primary practice location

10879 Clemson Blvd
Seneca, SC 29678-1303

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

257 W Kings Hwy
Eden, NC 27288-5009
Phone (336) 627-4263

Other identifiers 1

IdentifierTypeStateIssuer
2816OtherNCNC PT LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2816NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elderfit Physical Therapy and Consulting Inc. Physical Therapist PastSince Oct 26, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1639309859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10879 CLEMSON BLVD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296781303",
            "telephone_number": "864-482-0085",
            "fax_number": "864-482-0072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "257 W Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Eden",
            "state": "NC",
            "postal_code": "272885009",
            "country_code": "US",
            "telephone_number": "336-627-4263",
            "fax_number": "336-627-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "STEVEN",
        "middle_name": "R.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "2816",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PT LICENSE NUMBER",
            "identifier": "2816",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.