Active NPI
Andrea Phillips, DPT
- Physical Therapist
- Lake City, SC
National Provider Identifier
1942625660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6314
- Practice address
- 56 Genesis Dr
Lake City, SC 29560-5531 - Phone
- (843) 389-3685
- NPI assigned
- Mar 4, 2014
- Last updated
- Mar 4, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 6314 | SC | Primary |
Addresses
Primary practice location
56 Genesis Dr
Lake City, SC 29560-5531
Mailing address
56 Genesis Dr
Lake City, SC 29560-5531
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6314 | SC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393891200000",
"number": "1942625660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 GENESIS DR",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295605531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 GENESIS DR",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295605531",
"telephone_number": "843-389-3685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "ANDREA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-04",
"last_updated": "2014-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "6314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, SC
- Pee Dee Mental Health
- Pee Dee Mental Health Center
- Pee Dee Physical Therapy, Inc.
- Pee Deediabetic Consultants
- Alice Washington Peterson, LMT
- Piggly Wiggly Lake City Inc (price wise pharmacy # 48)
- Piggly Wiggly Lake City Inc (Piggly Wiggly Pharmacy)
- Piggly Wiggly Lake City, Inc. (Piggly Wiggly Pharmacy #48)
- Piggly Wiggly Lake City, Inc. (Piggly Wiggly Pharmacy #48)
- Jane Dixon Player, RPH,CDE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.