Clemson Sports Medicine and Rehabilitation, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CLEMSON SPORTS MEDICINE AND REHABILITATION, INC.

Doing business as

Myrtle Beach Physical Therapy

Practice address

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579-6706

Phone

(843) 491-4937

Fax

(843) 491-4938

NPI assigned

Jun 1, 2009

Last updated

Apr 28, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

CLEMSON SPORTS MEDICINE AND REHABILITATION, INC.As reported in NPPES

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

Authorized official

Name

Debbie Baxter

Title

Credentialing

Phone

(864) 482-0064

Specialties & licenses 1

Addresses

Other names 1

• Myrtle Beach Physical Therapy Doing business as

Part of

MB Sports Medicine Re

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1851527261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296331844",
            "telephone_number": "864-482-0064",
            "fax_number": "864-482-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "address_2": "STE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-491-4937",
            "fax_number": "843-491-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION, INC.",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "864-482-0064"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle Beach Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clear Cut Counseling LLC
• Cameron Clements, FNP
• Clemson Sports Medicine and Rehabilitation (Myrtle Beach Physical Therapy)
• Clemson Sports Medicine and Rehabilitation (Hand Therapy Plus)
• Clemson Sports Medicine and Rehabilitation Inc (Strand Therapy)
• Gregor G Cleveland, MD
• Kacee L Cleveland, LPC
• Alayna K Cline, OTR/L
• Danielle Marie Cline
• Laura Kathryn Close

• Durable Medical Equipment & Medical Supplies in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.