CMS-1500 Box 24J / 33a • NPI
1366567778
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
204C00000X (CMS 12)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine
Box 32 Service Location & ZIP+4
507 W PALMETTO ST, FLORENCE, SC, 29501-4427
✓ 9-Digit EDI 837 ZIP+4 (29501-4427)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1366567778 (ACCIDENT INJURY AND REHABILITATION PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1366567778 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ACCIDENT INJURY AND REHABILITATION PC |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine NUCC Code: 204C00000X (Neuromusculoskeletal Medicine, Sports Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 507 W PALMETTO ST, FLORENCE, SC, 29501-4427 |
| Practice Telephone / Fax | Tel: (843) 669-1010 | Fax: (843) 669-1054 |
| Administrative Mailing Address | 507 W PALMETTO ST, FLORENCE, SC, 29501-4427 |
| Enumeration & Last Sync | Enumerated: 2007-03-21 | CMS Record Updated: 2015-02-09 |
| Authorized Official | JENNIFER MCKAY (Office Manger) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (204C00000X)
What Does Taxonomy Code 204C00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 204C00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ACCIDENT INJURY AND REHABILITATION PC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111NR0400X — Chiropractor, RehabilitationPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation | State: SC | License: 2474 | Primary: Secondary |
111NR0400X — Chiropractor, RehabilitationPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation | State: SC | License: 3406 | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: SC | License: 11313 | Primary: Secondary |
332B00000X — Durable Medical Equipment & Medical SuppliesPlain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies | State: SC | License: 6253900001 | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: SC | License: 1091 | Primary: Secondary |
204C00000X — Neuromusculoskeletal Medicine, Sports MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine | State: SC | License: 11313 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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