Active NPI
Jacob Kingston, DPT
- Physical Therapist
- North Charleston, SC
National Provider Identifier
1760895833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7395
- Practice address
- 2070 Northbrook Blvd
North Charleston, SC 29406-9252 - Phone
- (843) 824-2183
- Fax
- (843) 553-3221
- NPI assigned
- Jun 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7395 | SC | Primary |
Addresses
Primary practice location
2070 Northbrook Blvd
North Charleston, SC 29406-9252
Mailing address
586 Lone Tree Dr
Mount Pleasant, SC 29464-8170
Phone (843) 884-7880
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 |
|---|---|---|---|
| 7395 | SC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402012800000",
"number": "1760895833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "586 LONE TREE DR",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294648170",
"telephone_number": "843-884-7880",
"fax_number": "843-884-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2070 NORTHBROOK BLVD",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069252",
"telephone_number": "843-824-2183",
"fax_number": "843-553-3221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGSTON",
"first_name": "JACOB",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-06",
"last_updated": "2014-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "7395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.