Individual provider Active NPI

Amy Mobley McCraw, DPT

  • Physical Therapist
  • West Columbia, SC
National Provider Identifier
1962673335
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5704 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 791-2000
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 5704 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amccraw6796@direct.lexmed.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150211001468 SC Practitioner - Physical Therapist in Private Practice 4082939228 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5704SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: amccraw6796@direct.lexmed.com

Organizations & group practices 3

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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1962673335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-791-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAW",
        "first_name": "AMY",
        "middle_name": "MOBLEY",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amccraw6796@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "123 E Medical Ln",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.