NPIMap

Organization Active NPI

Effingham Rehab Services, Inc.

Doing business as Spine & Sport Charleston

  • Physical Therapy Clinic/Center
  • North Charleston, SC
National Provider Identifier
1811218423
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EFFINGHAM REHAB SERVICES, INC.
Doing business as
Spine & Sport Charleston
Practice address
4600 Goer Dr
Ste 206
North Charleston, SC 29406-6500
Phone
(877) 826-1509
Fax
(912) 826-9767
NPI assigned
Jun 17, 2010
Last updated
Jun 17, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
EFFINGHAM REHAB SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Authorized official

Name
Sebrena Carolin Holmes Gibson
Title
Vpa
Phone
(877) 826-1509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4600 Goer Dr
Ste 206
North Charleston, SC 29406-6500

Mailing address

135 Goshen Road Ext
Ste 206
Rincon, GA 31326-5567

Other names 1

  • Spine & Sport Charleston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Effingham Rehab Services LLC7 organizations share this tax ID, including this one
Part of
Effingham Rehab Services LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4600 Goer Dr
Ste 206
North Charleston, SC 29406
Phone (877) 826-1509

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1811218423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT",
            "address_2": "STE 206",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 GOER DR",
            "address_2": "STE 206",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066500",
            "telephone_number": "877-826-1509",
            "fax_number": "912-826-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFINGHAM REHAB SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EFFINGHAM REHAB SERVICES, INC.",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "HOLMES GIBSON",
        "authorized_official_first_name": "SEBRENA",
        "authorized_official_middle_name": "CAROLIN",
        "authorized_official_title_or_position": "VPA",
        "authorized_official_telephone_number": "877-826-1509"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine & Sport Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.