Individual provider Active NPI

Paul Michael John, PT, MS, ATC

  • Orthopedic Physical Therapist
  • Florence, SC
National Provider Identifier
1740487339
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
4311 Issued in SC
Practice address
315 N Beltline Dr Ste D
Florence, SC 29501-7420
Phone
(843) 407-7010
Fax
(843) 407-7814
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 4311 SC
Orthopedic Physical Therapist 2251X0800X 4311 SC Primary
Athletic Trainer 2255A2300X 496 SC

Addresses

Primary practice location

315 N Beltline Dr Ste D
Florence, SC 29501-7420

Mailing address

315 N Beltline Dr Ste D
Florence, SC 29501-7420
Phone (843) 407-7010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728002056 SC Practitioner - Physical Therapist in Private Practice 2365735362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Profection Therapy LLCGroup PAC ID 5597058594, 6 clinicians

Practice addresses (Care Compare)

2811 W Palmetto St
Suite D
Florence, SC 29501-5931
Phone (843) 407-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4311SCMDSpeech-Language Pathologist
496SCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Profection Therapy LLC CurrentSince Jun 28, 2016 Accepting new patients

Locations

2811 W Palmetto St
Ste D
Florence, SC 29501
Phone (843) 407-7010

315 N Beltline Dr
Ste D
Florence, SC 29501
Phone (843) 407-7010

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1740487339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N BELTLINE DR STE D",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295017420",
            "telephone_number": "843-407-7010",
            "fax_number": "843-407-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N BELTLINE DR STE D",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295017420",
            "telephone_number": "843-407-7010",
            "fax_number": "843-407-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT, MS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "SC",
            "license": "4311",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SC",
            "license": "4311",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.