Active NPI
Robert Duncan Geddens, D.P.T.
- Physical Therapist
- Columbia, SC
National Provider Identifier
1689773087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5168
- Practice address
- 4500 8TH Division Rd
Columbia, SC 29207-5700 - Phone
- (803) 751-0321
- Fax
- (803) 751-0321
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5168 | SC | Primary |
Addresses
Primary practice location
4500 8TH Division Rd
Columbia, SC 29207-5700
Mailing address
4500 8TH Division Rd
Columbia, SC 29207-5700
Phone (803) 751-2618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689773087 | Other | SC | FEDERAL GOVERNMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5168 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1689773087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 8TH DIVISION RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-2618",
"fax_number": "803-751-2689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 8TH DIVISION RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-0321",
"fax_number": "803-751-0321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDDENS",
"first_name": "ROBERT",
"middle_name": "DUNCAN",
"name_prefix": "Mr.",
"credential": "D.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL GOVERNMENT",
"identifier": "1689773087",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.