Active NPI
Deryl Damone Leaphart, P.T.
- Physical Therapist
- Lexington, SC
National Provider Identifier
1639529365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 764
- Practice address
- 2463 Augusta Hwy
Lexington, SC 29072-2215 - Phone
- (803) 821-3438
- Fax
- (803) 821-3466
- NPI assigned
- Jun 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 764 | SC | Primary |
Addresses
Primary practice location
2463 Augusta Hwy
Lexington, SC 29072-2215
Mailing address
2463 Augusta Hwy
Lexington, SC 29072-2215
Phone (803) 821-3438
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 764 | SC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1639529365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2463 AUGUSTA HWY",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290722215",
"telephone_number": "803-821-3438",
"fax_number": "803-821-3466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2463 AUGUSTA HWY",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290722215",
"telephone_number": "803-821-3438",
"fax_number": "803-821-3466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAPHART",
"first_name": "DERYL",
"middle_name": "DAMONE",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-14",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.