NPIMap

Organization Active NPI

Team Rehab Physical Therapy, P.C.

  • Physical Therapist
  • Daniel Island, SC
National Provider Identifier
1659799625
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023905 Issued in NY
Legal business name
TEAM REHAB PHYSICAL THERAPY, P.C.
Practice address
212 Brailsford St
Daniel Island, SC 29492-7459
Phone
(516) 662-9962
Fax
(800) 968-8969
NPI assigned
Apr 6, 2014
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Jennifer Olsen, P.T., D.P.T.NPI 1477614808
Title
President
Phone
(516) 662-9962

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 023905 NY Primary

Addresses

Primary practice location

212 Brailsford St
Daniel Island, SC 29492-7459

Mailing address

PMB #373
186 Seven Farms Drive, Ste F
Daniel Island, SC 29492
Phone (516) 662-9962

Other names 1

  • Olsen Physical Therapy, P.C. Former legal business name

National Provider Directory

National Provider Directory

Locations

10 Fort Salonga Rd
#2A
Fort Salonga, NY 11768
Phone (631) 343-9194

10 Fort Salonga Rd
Ste 15A
Fort Salonga, NY 11768
Phone (631) 343-9194

Practitioners & affiliated clinicians

Practitioners 2

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": "1396742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1659799625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB #373",
            "address_2": "186 SEVEN FARMS DRIVE, STE F",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "29492",
            "telephone_number": "516-662-9962",
            "fax_number": "800-968-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 BRAILSFORD ST",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294927459",
            "telephone_number": "516-662-9962",
            "fax_number": "800-968-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM REHAB PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-06",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-662-9962",
        "authorized_official_credential": "P.T., D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olsen Physical Therapy, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Olsen Physical Therapy, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Daniel Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.