NPIMap

Organization Active NPI

Carolina Sportscare and Physical Therapy

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1659306785
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CAROLINA SPORTSCARE AND PHYSICAL THERAPY
Practice address
1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476
Phone
(843) 521-1970
Fax
(843) 521-0908
NPI assigned
Jul 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Holly Konoza
Title
Owner
Phone
(843) 521-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476

Mailing address

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476
Phone (843) 521-1970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000751 SC Part B Supplier - Clinic/Group Practice 0648184937 Receives reassigned benefits from 19 practitioners
Practice locations: Beaufort, SC; Okatie, SC; Saint Helena Island, SC

National Provider Directory

National Provider Directory

Locations

1076 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 521-1970

1900 Boundary St
Ste 101
Beaufort, SC 29902
Phone (843) 521-1970

43 Marina Dr
Saint Helena Island, SC 29920
Phone (843) 521-1970

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659306785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "SUITE 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025476",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "SUITE 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025476",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SPORTSCARE AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KONOZA",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-521-1970"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.