Individual provider Active NPI

Robert Duncan Geddens, D.P.T.

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1689773087
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5168 Issued in SC
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

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1689773087OtherSCFEDERAL 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

LicenseStateTypeSpecialty
5168SCMDPhysical 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.

Verify at the official NPI Registry.