Individual provider Active NPI

Bethany Weinmann, PT, DPT

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1942545140
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12453 Issued in SC
Practice address
130 Crisanto Ave Ste a
Fort Mill, SC 29715-6272
Phone
(803) 746-4655
NPI assigned
Nov 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01476000 NJ
Physical Therapist 225100000X 12453 SC Primary

Addresses

Primary practice location

130 Crisanto Ave Ste a
Fort Mill, SC 29715-6272

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Other practice location 1

7 Carnegie Plz
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130321000014 NJ Practitioner - Physical Therapist in Private Practice 6800031949 Reassigns benefits to 1 organization
I20240828002746 SC Practitioner - Physical Therapist in Private Practice 6800031949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Focus, Inc.Group PAC ID 5890851406, 39 clinicians

Practice addresses (Care Compare)

130 Crisanto Ave
Suite a
Fort Mill, SC 29715-6272
Phone (803) 746-4655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12453SCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Focus, Inc. Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
New Jersey Pain Care Center PC Physical Therapist CurrentSince Mar 3, 2022 Accepting new patients
Ivyrehab Focus, Inc. CurrentSince Aug 5, 2024 Accepting new patients
New Jersey Pain Care Center PC CurrentSince Mar 3, 2022 Accepting new patients
University Spine and Pain PC Past Accepting new patients

Locations

44 State Rt 23
Ste 15B
Riverdale, NJ 07457
Phone (973) 400-1716

130 Crisanto Ave
Ste A
Fort Mill, SC 29715
Phone (803) 487-5638

439 Channel Rd
Ste 102
Lake Wylie, SC 29710
Phone (619) 977-0480

1738 Celanese Rd
#102
Rock Hill, SC 29732
Phone (803) 670-3067

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1942545140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CRISANTO AVE STE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156272",
            "telephone_number": "803-746-4655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Carnegie Plz",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080031000",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEINMANN",
        "first_name": "BETHANY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01476000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.