Active NPI
Abby Raye Pallister
- Physical Therapy Assistant
- Beaufort, SC
National Provider Identifier
1982005690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3179
- Practice address
- 1076 Ribaut Rd Ste 102
Beaufort, SC 29902-5490 - Phone
- (843) 521-1970
- Fax
- (843) 521-0908
- NPI assigned
- Sep 12, 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 Therapy Assistant | 225200000X | 3179 | SC | Primary |
Addresses
Primary practice location
1076 Ribaut Rd Ste 102
Beaufort, SC 29902-5490
Mailing address
1076 Ribaut Rd Ste 102
Beaufort, SC 29902-5490
Phone (843) 521-1970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3179 | Other | SC | PTA |
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 |
|---|---|---|---|
| 3179 | SC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1982005690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1076 RIBAUT RD STE 102",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299025490",
"telephone_number": "843-521-1970",
"fax_number": "843-521-0908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1076 RIBAUT RD STE 102",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299025490",
"telephone_number": "843-521-1970",
"fax_number": "843-521-0908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLISTER",
"first_name": "ABBY",
"middle_name": "RAYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "3179",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA",
"identifier": "3179",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaufort, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.