Individual provider Active NPI

William Oliver Reeside III, DPT

  • Orthopedic Physical Therapist
  • Lexington, SC
National Provider Identifier
1720394760
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
6268 Issued in SC
Practice address
109 Park Place CT
Lexington, SC 29072-6690
Phone
(803) 933-6784
NPI assigned
Aug 27, 2010
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6268 SC
Physical Therapist 225100000X 12762 NC
Orthopedic Physical Therapist 2251X0800X 6268 SC Primary

Addresses

Primary practice location

109 Park Place CT
Lexington, SC 29072-6690

Mailing address

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

Other identifiers 2

IdentifierTypeStateIssuer
12762OtherNCNC BOARD OF PT EXAMINERS
6268OtherSCSC BOARD OF PT EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000105 SC Practitioner - Physical Therapist in Private Practice 3577723790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

109 Park Place CT
Lexington, SC 29072-6690
Phone (803) 256-4107

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6268NCMDPsychologist
6268SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Jul 1, 2017 Accepting new patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Jul 1, 2017 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA Past Accepting new patients
Healthquest Physical Therapy LLC Physical Therapist PastSince Aug 1, 2022 Accepting new patients

Locations

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

1013 Lake Murray Blvd
Irmo, SC 29063
Phone (803) 732-5887

109 Park Place Ct
Lexington, SC 29072
Phone (803) 933-6784

Interoperability endpoints

  • Direct secure messaging: william.reeside.1@5499.direct.athenahealth.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1720394760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013520",
            "telephone_number": "803-256-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PARK PLACE CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726690",
            "telephone_number": "803-933-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESIDE",
        "first_name": "WILLIAM",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6268",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "12762",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SC",
            "license": "6268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF PT EXAMINERS",
            "identifier": "12762",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF PT EXAMINERS",
            "identifier": "6268",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.