Individual provider Active NPI

Michelle Ponsler Sine, P.T.

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1841241098
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4534 Issued in SC
Practice address
2200 Crow LN Ste 201
Myrtle Beach, SC 29577-1663
Phone
(843) 293-7713
NPI assigned
May 12, 2006
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 4534 SC Primary

Addresses

Primary practice location

2200 Crow LN Ste 201
Myrtle Beach, SC 29577-1663

Mailing address

PO Box 421718
Georgetown, SC 29442-4203

Other identifiers 1

IdentifierTypeStateIssuer
TH1340MedicaidSC

Other names 1

  • Michelle Louise Ponsler Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address records@tidelands-health.direct.kno2fy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231001681 SC Practitioner - Physical Therapist in Private Practice 6305270299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 Crow LN
Suite 201
Myrtle Beach, SC 29577-1663
Phone (843) 848-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4534SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Physician Associates, LLC CurrentSince Oct 26, 2019 Accepting new patients
Georgetown Physician Associates, LLC Current Accepting new patients
Georgetown Physician Associates LLC CurrentSince Oct 26, 2019 Accepting new patients
Atlantic Physical Therapy & Rehabilitation, Inc Physical Therapist Past Accepting new patients
Georgetown Physician Services, LLC Past Accepting new patients

Locations

2347 S Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-2443

2200 Crow Ln
Ste 201
Myrtle Beach, SC 29577
Phone (843) 848-5000

12117 Ocean Hwy
Pawleys Island, SC 29585
Phone (843) 237-8231

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1841241098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CROW LN STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771663",
            "telephone_number": "843-293-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINE",
        "first_name": "MICHELLE",
        "middle_name": "PONSLER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1340",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@tidelands-health.direct.kno2fy.com",
            "affiliation": "N",
            "address_1": "2200 Crow Ln Ste 201",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295771663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PONSLER",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.