KIMBERLY T ETHRIDGE PT
NPI 1619205499
Physical Therapist in Mt Pleasant, SC
About Kimberly T Ethridge Pt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY T ETHRIDGE PT (NPI 1619205499) is an individual physical therapist in Mt Pleasant, South Carolina, licensed in South Carolina (3000) and active in the NPI registry since December 2009. She is a graduate of Medical University Of South Carolina College Of Medicine (1996).
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kimberly T Ethridge Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Ethridge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mt Pleasant, SC 29464
- Reassigned Medicare billing, South Carolina enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29464 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Ethridge's NPI number?
The NPI number for Kimberly Ethridge is 1619205499. It was assigned to this individual provider in the NPPES registry on December 7, 2009.
Where is Kimberly Ethridge located?
Kimberly Ethridge practices at 1476 Long Grove Dr, Mt Pleasant, SC 29464. The listed phone number is (843) 216-3535.
What is Kimberly Ethridge's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Kimberly Ethridge enrolled in Medicare?
Yes. Kimberly Ethridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kimberly Ethridge's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Ethridge reassigns Medicare benefits to Olympic Physical Therapy LLC (Mt Pleasant, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Ethridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Ethridge was last updated on July 26, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly T Ethridge, PT · NPI 1619205499
Physical Therapist provider in Mt Pleasant, South Carolina. Individual provider, active in the CMS NPPES registry since December 7, 2009.
## Identity
- **NPI:** 1619205499 (Entity type: Individual)
- **Enumerated:** December 7, 2009
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** 3000 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 1476 LONG GROVE DR, Mt Pleasant, SC 29464-7571
- **Phone:** (843) 216-3535
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Olympic Physical Therapy LLC (NPI 1710060868, Mt Pleasant, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical University Of South Carolina College Of Medicine, class of 1996
## Record status
- **NPPES last updated:** July 26, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1619205499) · Data from the CMS NPPES public registry.