Individual provider Active NPI

Jamie Lynn Kornegay

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1881775286
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5754 Issued in SC
Practice address
2267 Ashley River Rd
Charleston, SC 29414-4736
Phone
(843) 576-4121
Fax
(843) 793-3575
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 5754 SC Primary

Addresses

Primary practice location

2267 Ashley River Rd
Charleston, SC 29414-4736

Mailing address

5111 N Rhett Ave
North Charleston, SC 29405-4219
Phone (843) 576-4121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090105000368 SC Practitioner - Physical Therapist in Private Practice 1951302793 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imagine Physical Therapy in West Ashley LLCGroup PAC ID 6800072562, 3 clinicians

Practice addresses (Care Compare)

2267 Ashley River Rd
Charleston, SC 29414-4736
Phone (843) 576-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5754SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Love of Language CurrentSince Aug 29, 2024 Accepting new patients
Rehabilitation Centers of Charleston, LLC Physical Therapist Past Accepting new patients
Birmingham Physical Therapy & Sports Medicine Inc Physical Therapist PastSince Jul 1, 2005 Accepting new patients
Atlanta Rehabilitation and Performance Center Past Accepting new patients
Atlanta Rehabilitation and Performance Center PastSince Jun 16, 2003 Accepting new patients

Locations

142 Sportsman Island Dr
Ste F
Charleston, SC 29492
Phone (843) 377-8820

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1881775286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N RHETT AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054219",
            "telephone_number": "843-576-4121",
            "fax_number": "843-793-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294144736",
            "telephone_number": "843-576-4121",
            "fax_number": "843-793-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNEGAY",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.