Tad B Martin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3924 Issued in SC

Practice address

1510 Ribaut Rd
Port Royal, SC 29935-1403

Phone

(843) 524-3241

Fax

(843) 322-3240

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Theodore (Tad) B Martin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1801832480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-758-2600",
            "fax_number": "803-253-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351403",
            "telephone_number": "843-524-3241",
            "fax_number": "843-322-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TAD",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3924",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THEODORE (TAD)",
            "last_name": "MARTIN",
            "middle_name": "B",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapist in Port Royal, SC
• Providers in Port Royal, 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 Nov 15, 2010; 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.