Individual provider Active NPI

Michael P. Champoux, PTA

  • Physical Therapy Assistant
  • Bluffton, SC
National Provider Identifier
1982825634
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1810 Issued in SC
Practice address
800 Fording Island Rd
Bluffton, SC 29910-4845
Phone
(843) 815-2555
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1810 SC Primary

Addresses

Primary practice location

800 Fording Island Rd
Bluffton, SC 29910-4845

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982825634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FORDING ISLAND RD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104845",
            "telephone_number": "843-815-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPOUX",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "1810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.