NPIMap

Organization Active NPI

Cora South Carolina LLC

Doing business as CORA Physical Therapy - North Charleston

  • Rehabilitation Clinic/Center
  • North Charleston, SC
National Provider Identifier
1881177855
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CORA SOUTH CAROLINA LLC
Doing business as
CORA Physical Therapy - North Charleston
Practice address
5625 Rivers Ave
North Charleston, SC 29406-6022
Phone
(843) 507-8473
Fax
(843) 868-8043
NPI assigned
Sep 14, 2018
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Stephen Krzyminski
Title
Executive Vice President
Phone
(419) 221-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

5625 Rivers Ave
North Charleston, SC 29406-6022

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other names 1

  • CORA Physical Therapy - North Charleston Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181112001214 SC Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3173766334 5 other NPIs on this enrollment
Practice locations: Charleston, SC; Johns Island, SC; North Charleston, SC; Summerville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881177855. Details of each certification follow.

  • CCN 426653 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 426653

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CORA PHYSICAL THERAPY-NORTH CHARLESTON
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 16, 2019
Last certification
Feb 12, 2019
Ownership / control type
Proprietary
Facility address
5625 Rivers Ave
North Charleston, SC 29406

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1881177855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066022",
            "telephone_number": "843-507-8473",
            "fax_number": "843-868-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORA SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-14",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6717"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - North Charleston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Physical Therapy - North Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.