Jennifer J Wakeman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6193 Issued in SC

Practice address

727 SE Main St
Ste 200
Simpsonville, SC 29681-3247

Phone

(864) 454-6670

NPI assigned

Jun 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Greenville Proaxis Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD (past)
• Greenville Proaxis Therapy, LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  NPD (past)
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  NPD (past)
• Proaxis Spartanburg, LLC

  • Physical Therapist
  • Spartanburg, SC
  • NPI 1902841794
  NPD (past)

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1891006003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST",
            "address_2": "STE 200",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813247",
            "telephone_number": "864-454-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEMAN",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawn Waddell, HIS
• Richard Alan Wade
• Rekha Wadhwa, DDS, MS
• Debra Ann Wagner, MD
• Lily Sara Waitsman, P.T
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP.
• Jan Waldt, OT

• Physical Therapist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.