Individual provider Active NPI

Kelly J Lenz, PT

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1891775045
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9802 Issued in SC
Practice address
1836 Ashley River Rd
Charleston, SC 29407-4781
Phone
(854) 202-8371
Fax
(854) 900-4102
NPI assigned
Jan 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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 9802 SC Primary

Addresses

Primary practice location

1836 Ashley River Rd
Charleston, SC 29407-4781

Mailing address

1836 Ashley River Rd
Charleston, SC 29407-4781
Phone (854) 202-8371

Other identifiers 1

IdentifierTypeStateIssuer
3650598MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129004557 SC Practitioner - Physical Therapist in Private Practice 0840479432 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9802SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cora South Carolina LLC CurrentSince Oct 21, 2023 Accepting new patients
Cora South Carolina LLC CurrentSince Oct 21, 2023 Accepting new patients
Cora South Carolina LLC Current Accepting new patients
Clinton Physical Therapy Center Physical Therapist Past Accepting new patients

Locations

876 Fording Island Rd
Ste 2
Bluffton, SC 29910
Phone (843) 507-8473

851 Heckle Blvd
Ste 115
Rock Hill, SC 29730
Phone (839) 388-0908

515 Carnes Crossing Blvd
Ste B
Summerville, SC 29486
Phone (843) 507-8190

Organizations & group practices 4

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": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1891775045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074781",
            "telephone_number": "854-202-8371",
            "fax_number": "854-900-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074781",
            "telephone_number": "854-202-8371",
            "fax_number": "854-900-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-21",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3650598",
            "state": "TN"
        }
    ],
    "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 Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.