NPIMap

Organization Active NPI

Cryowell Physical Therapy

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1730698556
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8180 Issued in SC
Legal business name
CRYOWELL PHYSICAL THERAPY
Practice address
37 Brendan Way
Greenville, SC 29615-3514
Phone
(687) 866-3646
Fax
(888) 651-5324
NPI assigned
Sep 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Authorized official

Name
Mr. Dwight Alexander Peeples Jr.
Title
Owner
Phone
(404) 320-0981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 8180 SC Primary

Addresses

Primary practice location

37 Brendan Way
Greenville, SC 29615-3514

Mailing address

3842 Mourning Dove Dr
Weddington, NC 28104-8636
Phone (404) 308-0981

Other identifiers 1

IdentifierTypeStateIssuer
TH3404MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1730698556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3842 MOURNING DOVE DR",
            "city": "WEDDINGTON",
            "state": "NC",
            "postal_code": "281048636",
            "telephone_number": "404-308-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BRENDAN WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153514",
            "telephone_number": "687-866-3646",
            "fax_number": "888-651-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYOWELL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "PEEPLES",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-320-0981",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH3404",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 25, 2017; 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.