Active NPI
Courtney Kelso, DPT
- Physical Therapist
- West Columbia, SC
National Provider Identifier
1689906653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6129
- Practice address
- 2993 Sunset Blvd
West Columbia, SC 29169-3421 - Phone
- (803) 939-0026
- NPI assigned
- Feb 2, 2010
- Last updated
- Dec 21, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 6129 | SC | Primary |
Addresses
Primary practice location
2993 Sunset Blvd
West Columbia, SC 29169-3421
Mailing address
2993 Sunset Blvd
West Columbia, SC 29169-3421
Phone (803) 939-0026
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6129 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482278400000",
"number": "1689906653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2993 SUNSET BLVD",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693421",
"telephone_number": "803-939-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2993 SUNSET BLVD",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693421",
"telephone_number": "803-939-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELSO",
"first_name": "COURTNEY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-02",
"last_updated": "2016-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "6129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.