Individual provider Active NPI

Jason Daniel Webster

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1730911546
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12441 Issued in SC
Practice address
210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706
Phone
(843) 353-3460
Fax
(843) 353-3461
NPI assigned
Aug 19, 2024
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 12441 SC Primary

Addresses

Primary practice location

210 Village Center Blvd Ste 100
Myrtle Beach, SC 29579-6706

Mailing address

210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113004360 SC Practitioner - Physical Therapist in Private Practice 6800320813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

315 Medical Pkwy
Suite 150
Greer, SC 29650-2456
Phone (864) 797-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Aug 26, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

315 Medical Pkwy
Ste 150
Greer, SC 29650
Phone (864) 695-1418

4237 River Hills Dr
Ste 120
Little River, SC 29566
Phone (843) 249-5616

8161 Rourk St
Myrtle Beach, SC 29572
Phone (843) 449-3685

2125 E Main St
Ste 400
Spartanburg, SC 29307
Phone (864) 285-3615

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1730911546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 140",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "JASON",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.