Individual provider Active NPI

Courtney Etheridge

  • Orthopedic Physical Therapist
  • Greer, SC
National Provider Identifier
1801530944
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
315 Medical Pkwy
Greer, SC 29650-2456
Phone
(864) 797-9600
NPI assigned
Apr 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

315 Medical Pkwy
Greer, SC 29650-2456

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC CurrentSince May 16, 2022 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince May 16, 2022 Accepting new patients
Prisma Health University Medical Group PastSince May 1, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

315 Medical Pkwy
Greer, SC 29650
Phone (864) 797-9600

315 Medical Pkwy
Ste 150
Greer, SC 29650
Phone (864) 695-1418

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": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1801530944",
    "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": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MEDICAL PKWY",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502456",
            "telephone_number": "864-797-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.