Active NPI
Courtney Joy Comstock Elizondo, DPT
- Physical Therapist
- Aiken, SC
National Provider Identifier
1790208254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8371
- Practice address
- 943 Pine Log Rd
Aiken, SC 29803-7330 - Phone
- (803) 649-9797
- Fax
- (803) 642-2759
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 8371 | SC | Primary |
Addresses
Primary practice location
943 Pine Log Rd
Aiken, SC 29803-7330
Mailing address
943 Pine Log Rd
Aiken, SC 29803-7330
Phone (803) 649-9797
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 |
|---|---|---|---|
| 8371 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1790208254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "943 PINE LOG RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298037330",
"telephone_number": "803-649-9797",
"fax_number": "803-642-2759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "943 PINE LOG RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298037330",
"telephone_number": "803-649-9797",
"fax_number": "803-642-2759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMSTOCK ELIZONDO",
"first_name": "COURTNEY",
"middle_name": "JOY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "8371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.