Southern Lakes Therapy LLC
NPI 1700212420 · Physical Therapist · Manning, SC
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Lakes Therapy LLC is a Physical Therapist organization in Manning, SC (NPI 1700212420).
Provider details
- NPI number
- 1700212420
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Heather Goff, Coowner(803) 433-9001
- License
- 4166 (SC)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-09-26
- Last updated
- 2025-08-12
- Certified
- 2025-08-12
Frequently asked questions
- What is Southern Lakes Therapy LLC's NPI number?
- Southern Lakes Therapy LLC's National Provider Identifier (NPI) is 1700212420, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Lakes Therapy LLC?
- Southern Lakes Therapy LLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Southern Lakes Therapy LLC located?
- Southern Lakes Therapy LLC's practice location on file with NPPES is 297 W Boyce St, Manning, SC 29102.
- What is Southern Lakes Therapy LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Lakes Therapy LLC is (803) 433-9001.
- Does Southern Lakes Therapy LLC accept Medicare?
- Southern Lakes Therapy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Lakes Therapy LLC?
- The authorized official listed on Southern Lakes Therapy LLC's NPPES record is Heather Goff, Coowner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Lakes Therapy LLC's NPI active?
- Yes — Southern Lakes Therapy LLC's NPI (1700212420) is active in the NPPES registry as of the last update on 2025-08-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.