NPIMap

Organization Active NPI

Excel Rehabilitation and Sports

Doing business as Excel Rehabilitation and Sports Enhancement LLC

  • Physical Therapist
  • Clemson, SC
National Provider Identifier
1740358324
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EXCEL REHABILITATION AND SPORTS
Doing business as
Excel Rehabilitation and Sports Enhancement LLC
Practice address
501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone
(864) 654-2001
Fax
(800) 305-7112
NPI assigned
Dec 1, 2006
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Mr. Richard Leaver, PTNPI 1801994355
Title
Ceo
Phone
(166) 356-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X NU
Physical Therapist 225100000X NU Primary
Sports Physical Therapist 2251S0007X NU
Orthopedic Physical Therapist 2251X0800X NU
Occupational Therapist 225X00000X NU
Hand Occupational Therapist 225XH1200X NU

Addresses

Primary practice location

501 Forest LN
Suite a
Clemson, SC 29631-2621

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395
Phone (616) 356-5000

Other practice location 1

1700 Broad St Ste 120
Chattanooga, TN 37408-1834
Phone (423) 254-5461

Other practice location 2

862 Callen Ln NW Ste 100
Cleveland, TN 37312-6995
Phone (423) 254-5461

Other practice location 3

2158 Northgate Park Ln Ste 200
Chattanooga, TN 37415-6911
Phone (423) 254-5461

Other practice location 4

103 Halton Rd Ste B
Greenville, SC 29607-3507
Phone (864) 692-4605

Other practice location 5

3460 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4007
Phone (706) 719-2253

Other practice location 6

11091 N Radio Station Rd
Seneca, SC 29678-1142
Phone (864) 654-2001

Other practice location 7

313 Manufacturers Rd Ste C215
Chattanooga, TN 37405-3274
Phone (423) 254-5461

Other practice location 8

1664 E Main St
Easley, SC 29640-3790
Phone (864) 654-2001

Other practice location 9

7443 Commons Blvd Ste 112
Chattanooga, TN 37421-2895
Phone (423) 254-5461

Other names 1

  • Excel Rehabilitation and Sports Enhancement LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TN, GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070710000010 SC Part B Supplier - Clinic/Group Practice 1759481559 Receives reassigned benefits from 26 practitioners
Practice locations: Clemson, SC; Easley, SC; Greenville, SC; Seneca, SC
O20171115000824 TN Part B Supplier - Clinic/Group Practice 1759481559 Receives reassigned benefits from 26 practitioners
Practice locations: Cleveland, TN; Chattanooga, TN
O20241113001735 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759481559 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Oglethorpe, GA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Excel Rehab and Sports5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2158 Northgate Park Ln
Ste 200
Chattanooga, TN 37415
Phone (423) 254-5461

7443 Commons Blvd
Ste 112
Chattanooga, TN 37421
Phone (423) 254-5461

7443 Commons Blvd
Ste A
Chattanooga, TN 37421
Phone (423) 254-5461

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1740358324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FOREST LN",
            "address_2": "SUITE A",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312621",
            "telephone_number": "864-654-2001",
            "fax_number": "800-305-7112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Broad St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374081834",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "862 Callen Ln NW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373126995",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2158 Northgate Park Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374156911",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Halton Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296073507",
            "country_code": "US",
            "telephone_number": "864-692-4605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3460 Battlefield Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Oglethorpe",
            "state": "GA",
            "postal_code": "307424007",
            "country_code": "US",
            "telephone_number": "706-719-2253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11091 N Radio Station Rd",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296781142",
            "country_code": "US",
            "telephone_number": "864-654-2001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 Manufacturers Rd Ste C215",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374053274",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1664 E Main St",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296403790",
            "country_code": "US",
            "telephone_number": "864-654-2001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7443 Commons Blvd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374212895",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCEL REHABILITATION AND SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "LEAVER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "166-356-5000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Rehabilitation and Sports Enhancement LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.