SOUTHERN STATES PHYSICAL MEDICINE AND REHABILIATION CENTER (NPI# 1114943099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114943099 |
| Entity Type | Organization |
| Organization Name | SOUTHERN STATES PHYSICAL MEDICINE AND REHABILIATION CENTER |
| Other Organization Name | SOUTHERN STATES FAMILY HEALTH CENTER |
| Practice Address |
8763 Charlotte Hwy Fort Mill SC 29715-7589 |
| Mailing Address |
1002 N Woodland Dr Lancaster SC 29720-1966 |
| Practice Telephone | 8035488452 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLENN GEADA (OWNER) |
| Authorized Official Telephone | 8032838442 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 111N00000X | Chiropractor | 2158 | SC | Chiropractic Providers |
| X | 225100000X | Physical Therapist | 3884 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Southern States Family Health Center | Doing Business As Name - Organization |
| Street Address |
8763 CHARLOTTE HWY |
| City | FORT MILL |
| State | SC |
| Zip Code | 29715-7589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508816927 | Adam H Cooper | Chiropractor | 8763 Charlotte Hwy, Fort Mill, SC 29715-7589 | 2006-05-10 |
| 1164601233 | Dr Cooper Enterprise | Chiropractor | 8763 Charlotte Hwy, Fort Mill, SC 29707-7589 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590278 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1919 Springfield Parkway, Fort Mill, SD 29715 | 2020-08-25 |
| 1336759307 | Elizabeth Blakeney Sitton | Dentist | 3463 Us-21 #101, Fort Mill, SC 29715 | 2020-08-05 |
| 1730715293 | Fort Mill Dobys Bridge Dental LLC | Clinic/Center | 1500 Fort Mill Pkwy #108, Fort Mill, SC 29715 | 2020-03-17 |
| 1841728755 | Dennis Demetrius Williams | Specialist/Technologist | 1179 Madison Green Dr, Fort Mill, SC 29715 | 2017-05-23 |
| 1437684453 | Specialty Orthopaedics and Sports Medicine | Orthopaedic Surgery | 130 Crisanto Ave Ste B, Fort Mill, SC 29715 | 2017-04-27 |
| 1730624115 | Springfield Dentistry | Dentist | 452 Mercantile Place, Fort Mill, SC 29715 | 2016-12-21 |
| 1700335569 | Melby Transitions Mht LLC | Internal Medicine | 1148 Wessington Manor Ln, Fort Mill, SC 29715 | 2016-09-22 |
| 1629434071 | Palmetto Family Pharmacy Regent Park | Pharmacy | 1046 Regent Parkway, Suite 104, Fort Mill, SC 29715 | 2016-01-14 |
| 1619374220 | Rebecca Rowe | Speech-Language Pathologist | 8835 Gladden Hill Ln, Fort Mill, SC 29715 | 2014-11-25 |
| 1003248873 | Terri Hennessey | Speech-Language Pathologist | 1599 Farm House Dr, Fort Mill, SC 29715 | 2013-08-05 |
| Find all providers in zip 29715 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669037024 | Patrick Richard Klaus | Chiropractor | 3070 Drewsky Ln Unit 103, Fort Mill, SC 29715-0128 | 2019-05-01 |
| 1376008904 | Erin Magee | Chiropractor | 3071 Highway 21 Ste 103, Fort Mill, SC 29715-7206 | 2019-02-07 |
| 1093288474 | Michael B Mcintyre Jr. | Chiropractor | 1698 Highway 160 W Ste 140, Fort Mill, SC 29708-8033 | 2019-01-08 |
| 1538679022 | Chadwick Walker | Chiropractor | 3160 Highway 21 Ste 106, Fort Mill, SC 29715-8888 | 2017-10-10 |
| 1235501990 | Dynamic Chiropractic & Spinal Rehab | Chiropractor | 2714 Dunlin Dr, Fort Mill, SC 29707-9118 | 2015-10-21 |
| 1003235854 | Theresa Lobbestael | Chiropractor | 985 Market St Ste 201, Fort Mill, SC 29708-6533 | 2014-04-09 |
| 1457779969 | Ringston Chiropractic, PC | Chiropractor | 1162 Fort Mill Hwy Ste D, Fort Mill, SC 29707-7709 | 2014-04-01 |
| 1144560269 | Corey Riser | Chiropractor | 1674 Hwy 160 W, Fort Mill, SC 29708 | 2013-02-26 |
| 1164776183 | Logan Dean Evans | Chiropractor | 1245 Rosemont Dr Ste 120, Fort Mill, SC 29707-7765 | 2012-10-29 |
| 1922354034 | Jessica Harden | Chiropractor | 3071 Highway 21 Byp, Ste 103, Fort Mill, SC 29715-7205 | 2012-07-25 |
| Find all providers in FORT MILL | ||||
Please comment or provide details below to improve the information on SOUTHERN STATES PHYSICAL MEDICINE AND REHABILIATION CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.