Individual provider Active NPI

Randall Lee Eads, PT, DPT, OCS, CSCS

  • Physical Therapist
  • Moncks Corner, SC
National Provider Identifier
1750818506
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8623 Issued in SC
Practice address
441 Drive in LN
Moncks Corner, SC 29461-3154
Phone
(843) 989-0199
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8623 SC Primary

Addresses

Primary practice location

441 Drive in LN
Moncks Corner, SC 29461-3154

Mailing address

441 Drive in LN
Moncks Corner, SC 29461-3154
Phone (843) 989-0199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731000954 SC Practitioner - Physical Therapist in Private Practice 5395016059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Sports Medicine and Orthopaedic CenterGroup PAC ID 8527972637, 43 clinicians

Practice addresses (Care Compare)

2760 Tricom St
North Charleston, SC 29406-9169
Phone (843) 300-8585

441 Dr in LN
Suite B
Moncks Corner, SC 29461-3154
Phone (843) 789-0199

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8623SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc Physical Therapist CurrentSince Jun 8, 2017 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jun 8, 2017 Accepting new patients
South Carolina Sports Medicine & Orthopaedic Center CurrentSince Jul 10, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2791 Tricom St
Ste 102
North Charleston, SC 29406
Phone (843) 790-8520

9100 Medcom St
North Charleston, SC 29406
Phone (843) 569-3367

2760 Tricom St
North Charleston, SC 29406
Phone (843) 300-8585

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

800 Crescent Centre Dr
Ste 300
Franklin, TN 37067

800 Crescent Centre Dr
Ste 600
Franklin, TN 37067
Phone (615) 416-0199

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1516/brand/1/csg/1/fhir/r4
  • Direct secure messaging: randall.eads.1@1516.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1750818506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 DRIVE IN LN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613154",
            "telephone_number": "843-989-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 DRIVE IN LN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613154",
            "telephone_number": "843-989-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADS",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "credential": "PT, DPT, OCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.