1154895498 NPI number — MRS. JENNIFER HARPER POWERS DPT

Table of content: MRS. JENNIFER HARPER POWERS DPT (NPI 1154895498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154895498 NPI number — MRS. JENNIFER HARPER POWERS DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWERS
Provider First Name:
JENNIFER
Provider Middle Name:
HARPER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARPER
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
FERRELL
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154895498
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2113 ADAMS GROVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29203-6957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-767-4832
Provider Business Mailing Address Fax Number:
803-849-1522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2113 ADAMS GROVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29203-6957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-767-4832
Provider Business Practice Location Address Fax Number:
803-849-1522
Provider Enumeration Date:
01/21/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT.9474 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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