NPIMap

Organization Active NPI

Pro-Motion Physical Therapy of Florence, SC, LLC

  • Physical Therapist
  • Lake City, SC
National Provider Identifier
1821474115
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRO-MOTION PHYSICAL THERAPY OF FLORENCE, SC, LLC
Practice address
148 B Sauls Street
Lake City, SC 29560
Phone
(843) 374-0185
Fax
(843) 374-0189
NPI assigned
Aug 10, 2015
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Andrew Imbeau
Title
Managing Partner
Phone
(803) 233-1366

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

148 B Sauls Street
Lake City, SC 29560

Mailing address

PO Box 6526
Columbia, SC 29260-6526
Phone (803) 693-5040

Other practice location 1

610 W Palmetto St
Florence, SC 29501-4302
Phone (843) 407-0377

Other practice location 2

4420 Rosewood Dr
Columbia, SC 29209-2629
Phone (803) 233-1366

Other practice location 3

301 E Dekalb St # B
Camden, SC 29020-4495
Phone (803) 432-2432

Other practice location 4

958 E Main St Ste B
Spartanburg, SC 29302-2148
Phone (864) 278-0431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151103002310 SC Part B Supplier - Clinic/Group Practice 8820307580 Receives reassigned benefits from 22 practitioners
Practice locations: Camden, SC; Columbia, SC; Florence, SC; Lake City, SC; Spartanburg, SC

National Provider Directory

National Provider Directory

Locations

610 W Palmetto St
Florence, SC 29501
Phone (843) 374-0185

3080 Highway 15-401 E
Ste B
Mc Coll, SC 29570
Phone (843) 894-1141

958 E Main St
Spartanburg, SC 29302
Phone (864) 425-1572

958 E Main St
#B
Spartanburg, SC 29302
Phone (864) 278-0431

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1821474115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6526",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292606526",
            "telephone_number": "803-693-5040",
            "fax_number": "803-233-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 B SAULS STREET",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "29560",
            "telephone_number": "843-374-0185",
            "fax_number": "843-374-0189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 W Palmetto St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295014302",
            "country_code": "US",
            "telephone_number": "843-407-0377",
            "fax_number": "843-799-1944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4420 Rosewood Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292092629",
            "country_code": "US",
            "telephone_number": "803-233-1366",
            "fax_number": "803-233-1367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E Dekalb St # B",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "SC",
            "postal_code": "290204495",
            "country_code": "US",
            "telephone_number": "803-432-2432",
            "fax_number": "803-432-1779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "958 E Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293022148",
            "country_code": "US",
            "telephone_number": "864-278-0431",
            "fax_number": "864-278-0461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRO-MOTION PHYSICAL THERAPY OF FLORENCE, SC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "IMBEAU",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "803-233-1366"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.