Keandria R Elliott, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10566 Issued in SC

Practice address

344 View Dr
Blythewood, SC 29016-7252

Phone

(803) 400-6334

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Weston Group of South Carolina IncGroup PAC ID 2062651185, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Weston Group of South Carolina Inc

  • Physical Therapist
  • Bluffton, SC
  • NPI 1073957064
  Medicare reassignment Care Compare group NPD
• Speakeasy Therapy Factory Speech Language and Swallowing Services, LLC

  • Speech-Language Pathologist
  • Blythewood, SC
  • NPI 1376080812
  NPD

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1740866334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E LIBERTY SPRINGS ST",
            "city": "CROSS HILL",
            "state": "SC",
            "postal_code": "293323723",
            "telephone_number": "864-554-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 VIEW DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167252",
            "telephone_number": "803-400-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KEANDRIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeisha Dunson
• Charisse Dupree-Henegan, REGISTER NURSE
• Ellison Sloan Eargle, PTA
• Carlton Edwards III, PHARMD
• Shontrelle Edwards
• Engage Pediatric Therapy
• Ensight Health LLC
• Ensight Laboratories, LLC
• Everyday Wellness, LLC
• Christopher Chukwuemeka Ezeihuaku, MD

• Physical Therapist in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.