Individual provider Active NPI

Elizabeth W Sullivan, PT

  • Physical Therapist
  • Lexington, SC
National Provider Identifier
1881767614
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8251 Issued in SC
Practice address
229 Saluda Springs Rd
Lexington, SC 29072
Phone
(803) 359-0505
Fax
(803) 359-2206
NPI assigned
Nov 17, 2006
Last updated
Aug 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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 8251 SC Primary

Addresses

Primary practice location

229 Saluda Springs Rd
Lexington, SC 29072

Mailing address

141 Atrium Way
Columbia, SC 29223-6301
Phone (803) 788-8484

Other practice location 1

1212 York Rd
Suite C-101
Lutherville, MD 21093-6240
Phone (410) 321-0377

Other identifiers 1

IdentifierTypeStateIssuer
TH3382MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121000229 SC Practitioner - Physical Therapist in Private Practice 1658473038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians
Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

1602 N Hwy 17
Mount Pleasant, SC 29464-3310
Phone (843) 800-0773

320 W Coleman Blvd
Suite B
Mount Pleasant, SC 29464-3449
Phone (843) 823-5133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8251SCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Health Services Physical Therapist CurrentSince Apr 2, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Apr 2, 2024 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Apr 2, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Apr 2, 2024 Accepting new patients
Mady and Mules, PA PastSince Dec 2, 2006 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

320 W Coleman Blvd
Ste B
Mount Pleasant, SC 29464
Phone (843) 823-5133

1602 N Highway 17
Mt Pleasant, SC 29464
Phone (843) 800-0773

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1881767614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 ATRIUM WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236301",
            "telephone_number": "803-788-8484",
            "fax_number": "803-788-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 SALUDA SPRINGS RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-359-0505",
            "fax_number": "803-359-2206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 York Rd",
            "address_2": "Suite C-101",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "210936240",
            "country_code": "US",
            "telephone_number": "410-321-0377",
            "fax_number": "410-821-7517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "W",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH3382",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.