Jacob Cagney Amerson, DPT
Individual provider Active NPI Physical Therapist · Clemson, SC
NPI 1659752186 · NPPES record last updated Jul 27, 2016
Key facts
- NPI
- 1659752186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7742 (SC)
- Practice address
- 501 Forest LN
Suite a
Clemson, SC 29631-2621 - Phone
- (864) 654-2001
- Fax
- (800) 305-7112
- NPI assigned
- Jun 10, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- PT Solutions of Acworth LLC
Excel Rehabilitation and Sports
Practice addresses (Care Compare)
1322 E Washington St
Suite B1
Greenville, SC 29607-1867
Phone (864) 729-4081
501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone (864) 654-2001
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151001002188 | SC | Practitioner - Physical Therapist in Private Practice | 7315255858 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7742 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT Solutions of Acworth LLC | Physical Therapist | Current |
Accepting new patients |
| PT Solutions of Acworth LLC | Physical Therapist | Current |
Accepting new patients |
| Excel Rehabilitation and Sports | Physical Therapist | Current |
Accepting new patients |
| PT Solutions of Acworth LLC | Physical Therapist | Current | Accepting new patients |
| Excel Rehabilitation and Sports | Physical Therapist | Current |
Accepting new patients |
Locations
501 Forest Ln
Ste A
Clemson, SC 29631
Phone (864) 654-2001
1664 E Main St
Easley, SC 29640
Phone (864) 654-2001
103 Halton Rd
#B
Greenville, SC 29607
Phone (864) 336-8599
1322 E Washington St
Ste B1
Greenville, SC 29607
Phone (864) 729-4081
3919 S Highway 14
Greenville, SC 29615
Phone (864) 234-0491
11091 N Radio Station Rd
Seneca, SC 29678
Phone (864) 654-2001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7742 | SC | Yes |
Addresses
Primary practice location
501 Forest LN
Suite a
Clemson, SC 29631-2621
Mailing address
501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone (864) 654-2001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH2957 | Medicaid | SC |
Other providers in Clemson, SC
- Brandon John Albin
- Jonathan Michael Alexander
- Sarah McCormick Allen
- Ignacio Lorenzo Almada Perez
- Katherine Lee Ambrose
- Anchor of Hope Counseling of Clemson, PA
- Anderson Diagnostic Imaging, Inc
- Carrie S Anderson
- Channing Nathaniel Anderson
- Angela Hebert Hayden NP
All providers in Clemson, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.