Jag28 LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

JAG28 LLC

Practice address

420 Herlong Ave S Ste 104
Rock Hill, SC 29732-1091

Phone

(839) 274-3013

Fax

(839) 274-3014

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

James Joseph Grove

Title

President

Phone

(623) 670-0399

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ian Scollins, PT, DPT, ATC

  • Physical Therapist
  • Rock Hill, SC
  • NPI 1396177234
  Medicare reassignment Care Compare group NPD
• Rachel Johnson Wentling, DPT

  • Physical Therapist
  • Rock Hill, SC
  • NPI 1881769644
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1801655832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 SHARON RD UNIT S802",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113691",
            "telephone_number": "162-367-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 HERLONG AVE S STE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321091",
            "telephone_number": "839-274-3013",
            "fax_number": "839-274-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG28 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-670-0399"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Latrelle Jackson
• Tiffany Denise Jackson, MD
• William Jackson, MD
• Amanda Kristen Jacobs, PHARMD
• Brittany Jacobs, DPT
• Jam Medical Services, LLC
• Sheri Jamal, MD
• Timothy S James
• Walter James III, MD
• Pamela Lynn Jamieson

• Physical Therapist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.