Physical Medicine Devices LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

040678855 Issued in SC

Legal business name

PHYSICAL MEDICINE DEVICES LLC

Practice address

203 Amicks Ferry Rd
Ste 700
Chapin, SC 29036-8696

Phone

(866) 860-6650

Fax

(800) 995-2763

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Dennis J Sheahan

Title

Ceo

Phone

(866) 860-6650

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jeffery A Sheahan dba Physical Medicine Devices Former legal business name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1679660245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 COUNTRY SQUIRE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122202",
            "telephone_number": "866-860-6650",
            "fax_number": "800-995-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 AMICKS FERRY RD",
            "address_2": "STE 700",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368696",
            "telephone_number": "866-860-6650",
            "fax_number": "800-995-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE DEVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "SHEAHAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-860-6650"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "040678855",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "040678855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2009",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffery A Sheahan dba Physical Medicine Devices",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Denyse Gisele Peterson
• Bertha M Phillips, DCC, LMSW
• Charletta Borland Phillips, LPC
• James P Phillips, MD
• Robert Dean Phillips, PH.D.
• Lauren Pointer, LMSW
• Kathryn Porter
• Lauren M Powell, NP-C
• Prisma Health Imaging Centers, LLC
• Publix Super Markets Inc

• All providers in Chapin, SC
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.