William Johnson Fuller, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12810 Issued in SC

Practice address

116 Foxbank Plantation Blvd Ste E
Moncks Corner, SC 29461-6741

Phone

(843) 761-4622

Fax

(803) 759-8002

NPI assigned

Jul 31, 2023

Sex

Male

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 FL, SC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RSFH - Ati Physical Therapy LLCGroup PAC ID 3375849946, 98 clinicians

Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 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.

• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Charleston, SC
  • NPI 1659257806
  Medicare reassignment Care Compare group NPD
• RSFH - Ati Physical Therapy, LLC

  • Physical Therapist
  • Charleston, SC
  • NPI 1912378365
  Medicare reassignment Care Compare group NPD
• Optimal Performance and Physical Therapies Northdale LLC

  dba Optimal Performance and Physical Therapies Citrus Park

  • Physical Therapy Clinic/Center
  • Tampa, FL
  • NPI 1093399347

  Physical Therapist

  Medicare reassignment NPD
• Optimal Performance and Physical Therapies Northdale LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1740511195
  Medicare reassignment NPD
• RSFH - Ati Physical Therapy, LLC

  dba Ati Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • North Charleston, SC
  • NPI 1689405664

  Physical Therapist

  NPD
• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1750062824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 FOXBANK PLANTATION BLVD STE E",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294616741",
            "telephone_number": "843-761-4622",
            "fax_number": "803-759-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6633 Gunn Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336254056",
            "country_code": "US",
            "telephone_number": "813-519-0604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "WILLIAM",
        "middle_name": "JOHNSON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40202",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Fraga-Silver, LMFT
• Rose Berth Francois
• Alexa Sue Frankeny, PA-C
• Takila L Frazier
• Leeann Fuerst, RN, BSN
• Nytasia B Gaddist
• Stacy Gaillard
• Jonathan H Garger, DMD
• Lashaun Rana Garrett-Fears, M.A.
• Crystal Jeanine Gaskins

• Physical Therapist in Moncks Corner, SC
• Providers in Moncks Corner, 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 Feb 9, 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.