Prime Performance Rehab, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PRIME PERFORMANCE REHAB, LLC

Doing business as

Made 2 Move PT

Practice address

885 Island Park Dr
Daniel Island, SC 29492-7956

Phone

(843) 640-5244

NPI assigned

Jun 2, 2022

Organization subpart

No

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

Authorized official

Name

Elliot Lance, DR.NPI 1649894122

Title

Owner

Phone

(803) 394-6191

Specialties & licenses 1

Addresses

Other names 1

• Made 2 Move PT Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elliot Lance, PT, DPT

  • Physical Therapist
  • Charleston, SC
  • NPI 1649894122
  NPD Authorized official
• Jordan Paul

  • Physical Therapist
  • Charleston, SC
  • NPI 1588590061
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1992444319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 ASHCROFT AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054115",
            "telephone_number": "803-394-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 ISLAND PARK DR",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294927956",
            "telephone_number": "843-640-5244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3507 Iron Horse Rd",
            "address_purpose": "LOCATION",
            "city": "Ladson",
            "state": "SC",
            "postal_code": "294564347",
            "country_code": "US",
            "telephone_number": "843-640-5244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 Huger St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294034487",
            "country_code": "US",
            "telephone_number": "843-640-5244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1935 Belgrade Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294075715",
            "country_code": "US",
            "telephone_number": "843-640-5244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME PERFORMANCE REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "LANCE",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-394-6191",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Made 2 Move PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Kathryn Pheney
• Lee Picciuto, LISW-CP
• April Cara Pickeral
• Pleasant Life Chiropractic LLC
• PPCP Specialty Physicians , LLC
• Publix Super Markets, Inc. (Publix Pharmacy #2090)
• Margaret Ann Regnery, APRN
• Rehabilitation Centers of Charleston
• Laloma Reicher-Kagan, MSOT
• Mary T. Rhodes, PT

• Physical Therapy Clinic/Center in Daniel Island, SC
• Providers in Daniel Island, SC by specialty
• Physical Therapy Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.