Dylan Roger Hackley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4673 Issued in SC

Practice address

1715 Blanding St
Columbia, SC 29201-3441

Phone

(803) 799-3926

NPI assigned

Aug 9, 2021

Last updated

Aug 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1679248074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013441",
            "telephone_number": "803-799-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKLEY",
        "first_name": "DYLAN",
        "middle_name": "ROGER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1715 Blanding St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292013441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Elizabeth Habersberger
• Abby Habicht, M.S., CCC-SLP
• Habor Care Services LLC
• Rudayna Hachem, PHARM D
• Lynn Hunter Hackett, MD
• Monica Hagler Haddock, LMSW
• Majid Mark Haditaghi, MD
• De'Onna Hadley
• Hadora Hospice of the Carolinas
• Jack Hampton Hadwin

• Physical Therapy Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.