Organization Active NPI

St Clair Physical Therapy, LLC

Doing business as FYZICAL Therapy & Balance Centers - Northlake

  • Physical Therapist
  • Anderson, SC
National Provider Identifier
1649040361
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ST CLAIR PHYSICAL THERAPY, LLC
Doing business as
FYZICAL Therapy & Balance Centers - Northlake
Practice address
4122 Clemson Blvd Ste 4G
Anderson, SC 29621-1100
Phone
(864) 772-1004
Fax
(833) 796-6540
NPI assigned
Jan 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Sheri Lynn St. ClairNPI 1891028932
Title
Owner
Phone
(864) 772-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X

Addresses

Primary practice location

4122 Clemson Blvd Ste 4G
Anderson, SC 29621-1100

Mailing address

4122 Clemson Blvd Ste 4G
Anderson, SC 29621-1100
Phone (864) 772-1004

Other names 3

  • FYZICAL Therapy & Balance Centers - Northlake Doing business as
  • St Clair Physical Therapy Former legal business name
  • St. Clair Physical Therapy, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240918000921 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426599432 Receives reassigned benefits from 3 practitioners
Practice locations: Anderson, SC

National Provider Directory

National Provider Directory

Locations

4122 Clemson Blvd
Ste 4G
Anderson, SC 29621
Phone (864) 772-1004

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1649040361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 CLEMSON BLVD STE 4G",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211100",
            "telephone_number": "864-772-1004",
            "fax_number": "833-796-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 CLEMSON BLVD STE 4G",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211100",
            "telephone_number": "864-772-1004",
            "fax_number": "833-796-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "ST. CLAIR",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-772-1004"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy & Balance Centers - Northlake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FYZICAL Therapy & Balance Centers - Northlake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Clair Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "St. Clair Physical Therapy, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.