Individual provider Active NPI

Adrick Dorell Ceasar, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1730695255
Registry record updated Mar 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8756 Issued in SC
Practice address
226 Lake Fairfield Dr
Greenville, SC 29615-1548
Phone
(864) 881-2002
NPI assigned
Dec 20, 2017
Last updated
Mar 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8756 SC Primary

Addresses

Primary practice location

226 Lake Fairfield Dr
Greenville, SC 29615-1548

Mailing address

511 Grimes Dr
Simpsonville, SC 29681-6372

Other names 1

  • Adrick Dorell Harrison Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102001129 SC Practitioner - Physical Therapist in Private Practice 4183969686 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8756SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Integrated Therapy Centers, LLC Physical Therapist CurrentSince Oct 22, 2018 Accepting new patients
Klesis Health LLC Physical Therapist CurrentSince Jan 29, 2024 Accepting new patients

Locations

2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023

1007 Grove Rd
#A
Greenville, SC 29605

Organizations & group practices 2

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711756800000",
    "number": "1730695255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 GRIMES DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 LAKE FAIRFIELD DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151548",
            "telephone_number": "864-881-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEASAR",
        "first_name": "ADRICK",
        "middle_name": "DORELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2024-03-30",
        "certification_date": "2024-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRICK",
            "last_name": "HARRISON",
            "middle_name": "DORELL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.