Julie Hicks Traynham, PTA

Key facts

NPI

1982804480

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

1869 (SC)

Practice address

63 Blackstock Rd
Inman, SC 29349-1835

Phone

(864) 472-9055

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2007.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1982804480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BLACKSTOCK RD",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293491835",
            "telephone_number": "864-472-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BLACKSTOCK RD",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293491835",
            "telephone_number": "864-472-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYNHAM",
        "first_name": "JULIE",
        "middle_name": "HICKS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "1869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Inman, SC · Physical Therapy Assistant in South Carolina