Clemson Sports Medicine and Rehabilitation, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CLEMSON SPORTS MEDICINE AND REHABILITATION, INC

Practice address

800 Columbiana Dr
Suite 50
Irmo, SC 29063-7213

Phone

(803) 732-9294

Fax

(803) 732-9295

NPI assigned

Mar 7, 2008

Organization subpart

Yes

Parent organization

CLEMSON SPORTS MEDICINE AND REHABILITATION, INCAs reported in NPPES

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

Authorized official

Name

Debbie Baxter

Title

Credentialing

Phone

(864) 482-0064

Specialties & licenses 1

Addresses

Other names 1

• Sports Plus Doing business as

Part of

Clemson Sports Medicine

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1689844557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296331844",
            "telephone_number": "864-482-0064",
            "fax_number": "864-482-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 COLUMBIANA DR",
            "address_2": "SUITE 50",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637213",
            "telephone_number": "803-732-9294",
            "fax_number": "803-732-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION, INC",
        "enumeration_date": "2008-03-07",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "864-482-0064"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Micaela Anne Cisson
• Civic Care Soluctions LLC
• Kelly Clark
• Marisol Paige Ann Clark, DPT
• Christen Bowman Clements, D.C.
• Adrianna Coates
• Wade Hampton Cobb III
• Melanie Coetsee, MSP, CCC-SLP
• Rhyno Coetsee, PT
• Sandra Ann Coggins, RPH

• Physical Therapy Clinic/Center in Irmo, SC
• Providers in Irmo, SC by specialty
• Physical Therapy Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.