NPIMap

Organization Active NPI

Soulshine Pediatric Therapy

  • Physical Therapist
  • Johns Island, SC
National Provider Identifier
1700595022
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOULSHINE PEDIATRIC THERAPY
Practice address
3077 Vincent Astor Dr
Johns Island, SC 29455-8279
Phone
(678) 641-3767
NPI assigned
Nov 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Jayme Lee JarrettNPI 1598230104
Title
Owner
Phone
(678) 641-3767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3077 Vincent Astor Dr
Johns Island, SC 29455-8279

Mailing address

3077 Vincent Astor Dr
Johns Island, SC 29455-8279
Phone (678) 641-3767

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1700595022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 VINCENT ASTOR DR",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558279",
            "telephone_number": "678-641-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 VINCENT ASTOR DR",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558279",
            "telephone_number": "678-641-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSHINE PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "JAYME",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-641-3767"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.