Individual provider Active NPI

Danielle Elizabeth Wirick

  • Physical Therapist
  • Surfside Beach, SC
National Provider Identifier
1790340115
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8314 Issued in SC
Practice address
520 Highway 17 S
Surfside Beach, SC 29575-6088
Phone
(843) 238-9542
NPI assigned
May 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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 8314 SC Primary

Addresses

Primary practice location

520 Highway 17 S
Surfside Beach, SC 29575-6088

Mailing address

520 Highway 17 S
Surfside Beach, SC 29575-6088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119000510 SC Practitioner - Physical Therapist in Private Practice 2365831997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8314SCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management, LLC Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Oct 1, 2021 Accepting new patients
Select Physical Therapy Holdings Inc Past Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

11951 Grandhaven Dr
Murrells Inlet, SC 29576
Phone (843) 357-0200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1790340115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 HIGHWAY 17 S",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 HIGHWAY 17 S",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756088",
            "telephone_number": "843-238-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRICK",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.