Active NPI
Olivia Jean Pauken, DPT
- Physical Therapist
- Goose Creek, SC
National Provider Identifier
1740804145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11208
- Practice address
- 514 Saint James Ave Unit G
Goose Creek, SC 29445-2767 - Phone
- (843) 642-8660
- Fax
- (843) 642-8661
- NPI assigned
- Jun 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT018555 | OH | |
| Physical Therapist | 225100000X | 11208 | SC | Primary |
Addresses
Primary practice location
514 Saint James Ave Unit G
Goose Creek, SC 29445-2767
Mailing address
PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11208 | SC | MD | Pharmacist |
| PT018555 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1740804145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 306393",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372306393",
"telephone_number": "615-373-1350",
"fax_number": "615-373-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 SAINT JAMES AVE UNIT G",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294452767",
"telephone_number": "843-642-8660",
"fax_number": "843-642-8661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUKEN",
"first_name": "OLIVIA",
"middle_name": "JEAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-01",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT018555",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "11208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.