Individual provider Active NPI

Shannon Laing, P.T.

  • Physical Therapist
  • Mount Pleasant, SC
National Provider Identifier
1780652636
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2094 Issued in SC
Practice address
1909 N Highway 17 Ste Q
Mt Pleasant, SC 29464-7460
Phone
(843) 416-9026
NPI assigned
Mar 8, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 2094 SC Primary

Addresses

Primary practice location

1909 N Highway 17 Ste Q
Mt Pleasant, SC 29464-7460

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4990
Phone (630) 296-2222

Other identifiers 2

IdentifierTypeStateIssuer
861168971OtherSCEMPLOYER ID#
2094OtherSCPT LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051128000656 SC Practitioner - Physical Therapist in Private Practice 9830119411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
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

9100 Medcom St
North Charleston, SC 29406-9167

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
2094SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
South Carolina Sports Medicine & Orthopaedic Center CurrentSince Nov 6, 2021 Accepting new patients
Providence Orthopaedic Group LLC Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33299 Collection Ctr Dr
Chicago, IL 60693

1941 Savage Rd
Ste 300A
Charleston, SC 29407
Phone (843) 402-1495

1909 N Highway 17
Ste Q
Mt Pleasant, SC 29464
Phone (843) 416-9026

586 Lone Tree Dr
Mt Pleasant, SC 29464
Phone (843) 884-7880

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

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

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

Interoperability endpoints

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

Organizations & group practices 4

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780652636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404990",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N HIGHWAY 17 STE Q",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647460",
            "telephone_number": "843-416-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAING",
        "first_name": "SHANNON",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "2094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER ID#",
            "identifier": "861168971",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE #",
            "identifier": "2094",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 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.