Active NPI
Juan R Tolentino, PT
- Physical Therapist
- Aiken, SC
National Provider Identifier
1821160094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2993
- Practice address
- 690 Medical Park Dr
Aiken, SC 29801-6348 - Phone
- (803) 648-8344
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2993 | SC | Primary |
Addresses
Primary practice location
690 Medical Park Dr
Aiken, SC 29801-6348
Mailing address
1316 Wendell LN
Grovetown, GA 30813-5279
Phone (706) 860-7974
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH1283 | Medicaid | SC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2993 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1821160094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 WENDELL LN",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308135279",
"telephone_number": "706-860-7974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 MEDICAL PARK DR",
"city": "AIKEN",
"state": "SC",
"postal_code": "298016348",
"telephone_number": "803-648-8344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLENTINO",
"first_name": "JUAN",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "2993",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH1283",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.