Active NPI
Tracy Dewitt, PT
- Physical Therapist
- Mount Pleasant, SC
National Provider Identifier
1912496399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4430
- Practice address
- 1476 Long Grove Dr
Mount Pleasant, SC 29464-7571 - Phone
- (843) 216-3534
- NPI assigned
- May 1, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4430 | SC | Primary |
Addresses
Primary practice location
1476 Long Grove Dr
Mount Pleasant, SC 29464-7571
Mailing address
220 Beresford Creek St
Daniel Island, SC 29492-7518
Phone (843) 327-7655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4430 | SC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1912496399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 BERESFORD CREEK ST",
"city": "DANIEL ISLAND",
"state": "SC",
"postal_code": "294927518",
"telephone_number": "843-327-7655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1476 LONG GROVE DR",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294647571",
"telephone_number": "843-216-3534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "TRACY",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-01",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "4430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.