Organization Active NPI

CP&L

Doing business as Atlantic Spine and Health Clinic

  • Physical Medicine & Rehabilitation Physician
  • Mount Pleasant, SC
National Provider Identifier
1750988424
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CP&L
Doing business as
Atlantic Spine and Health Clinic
Practice address
1150 Hungryneck Blvd Ste D
Mount Pleasant, SC 29464-3484
Phone
(843) 884-1876
NPI assigned
Oct 6, 2020
Last updated
Jan 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Mrs. Jacqueline Fagioli
Title
Office Manager
Phone
(843) 884-1876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

1150 Hungryneck Blvd Ste D
Mount Pleasant, SC 29464-3484

Mailing address

1150 Hungryneck Blvd Ste D
Mount Pleasant, SC 29464-3484
Phone (843) 884-1876

Other identifiers 1

IdentifierTypeStateIssuer
1407103583OtherINDIVIDUAL NPI

Other names 1

  • Atlantic Spine and Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210107001610 SC Part B Supplier - Clinic/Group Practice 6608289806 Receives reassigned benefits from 8 practitioners
Practice locations: Mount Pleasant, SC
O20210804001912 SC DME Supplier - Medical Supply Company 6608289806 Practice locations: Mount Pleasant, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CP&L1150 Hungryneck Blvd, Mount Pleasant, SC 29464-3484(843) 884-1876 Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jan 7, 2021

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1750988424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 HUNGRYNECK BLVD STE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643484",
            "telephone_number": "843-884-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 HUNGRYNECK BLVD STE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643484",
            "telephone_number": "843-884-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CP&L",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "FAGIOLI",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-884-1876",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1407103583",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Spine and Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlantic Spine and Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.