Individual provider Active NPI

Samuel James Murdock, PT

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1811073463
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4695 Issued in SC
Practice address
727 SE Main St
Ste 200
Simpsonville, SC 29681-3247
Phone
(864) 454-6670
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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 4695 SC Primary

Addresses

Primary practice location

727 SE Main St
Ste 200
Simpsonville, SC 29681-3247

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000916 SC Practitioner - Physical Therapist in Private Practice 7810902194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

6525 Calhoun Memorial Hwy
Suite P
Easley, SC 29640-3682
Phone (864) 671-6162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4695SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Healthcare Services, LLC Physical Therapist Current Accepting new patients
Benchmark Healthcare Services Physical Therapist CurrentSince Feb 10, 2020 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Feb 10, 2020 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6525 Calhoun Memorial Hwy
Ste P
Easley, SC 29640
Phone (864) 671-6162

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

Organizations & group practices 4

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1811073463",
    "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",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST",
            "address_2": "STE 200",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813247",
            "telephone_number": "864-454-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.