Alexis Dubose

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

7405 Issued in SC

Practice address

421 Barony St Ste 3
Moncks Corner, SC 29461-3145

Phone

(843) 790-4093

NPI assigned

Oct 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Weston Group of South Carolina Inc

  • Physical Therapist
  • Bluffton, SC
  • NPI 1073957064
  Medicare reassignment
• Vantage Early Intervention, LLC

  • Early Intervention Provider Agency
  • Moncks Corner, SC
  • NPI 1033941356
  NPD
• Vantage Speech & Language LLC

  • Speech-Language Pathologist
  • Moncks Corner, SC
  • NPI 1063907731
  NPD

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1679395487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 KITFIELD RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294614209",
            "telephone_number": "843-499-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BARONY ST STE 3",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613145",
            "telephone_number": "843-790-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "7405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M Dorman, LPC
• Holly Dougharty
• Dr. Craig Thomas, LLC
• Dr. Terry D. Johnson, P.a.
• DRS. Kunkle and Powell, PA
• Matthew T. Dugan, LPC
• Jill Dunmire
• Randall Lee Eads, PT, DPT, OCS, CSCS
• Earnest E Kennedy Center
• Brigid Mary Eberenz, DPT

• Occupational Therapist in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.