NPIMap

Organization Active NPI

Charleston Pediatric Rehabilitation LLC

  • Behavior Analyst
  • Charleston, SC
National Provider Identifier
1982189718
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CHARLESTON PEDIATRIC REHABILITATION LLC
Practice address
1407 Ashley River Rd
Charleston, SC 29407-5305
Phone
(843) 364-5437
NPI assigned
Sep 27, 2018
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
Michael Coyle
Title
Owner
Phone
(843) 769-0663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1407 Ashley River Rd
Charleston, SC 29407-5305

Mailing address

2070 Northbrook Blvd Ste B4
North Charleston, SC 29406-9254
Phone (843) 364-5437

National Provider Directory

National Provider Directory
Tax ID family
Charleston Pediatric Rehabilitation LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1982189718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD STE B4",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069254",
            "telephone_number": "843-364-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075305",
            "telephone_number": "843-364-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON PEDIATRIC REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-769-0663"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.