Lynn S Destefano, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1480 Issued in SC

Practice address

1 Bishop Gadsden Way
Charleston, SC 29412-3506

Phone

(843) 406-6302

Fax

(843) 406-6540

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Olympic Physical Therapy LLCGroup PAC ID 6800856428, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Olympic Physical Therapy LLC

  • Physical Therapist
  • Mt Pleasant, SC
  • NPI 1710060868
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1699794164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1476 LONG GROVE DR",
            "address_2": "STE 1",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647571",
            "telephone_number": "843-406-6302",
            "fax_number": "843-406-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BISHOP GADSDEN WAY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123506",
            "telephone_number": "843-406-6302",
            "fax_number": "843-406-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "LYNN",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST/ RR#",
            "identifier": "650024090",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anushri Vijay Desai, MD
• Nimit Nitin Desai, MD
• Jenny Lee Desart, CRNA
• Jasmine Desdune, PHD
• Rebecca Rowsey Desso, M.D.
• Mary Detoma, FNP
• James B Detorre, MD
• Emma Dettmer, RN
• Nathan Deturk, MD, MBA
• Danielle Christine Detwiler, DDS

• Physical Therapist in Charleston, SC
• Providers in Charleston, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.