{"npi":"1124743331","type":"NPI-2","status":"active","name":{"display":"Foundation Physical Therapy, LLC","other":[],"organization_name":"FOUNDATION PHYSICAL THERAPY, LLC","authorised_official":"Samuel Jackson"},"specialty":{"primary_taxonomy":"261QP2000X","primary_taxonomy_description":"Physical Therapy Clinic/Center","slug":"physical-therapy-clinic-center","schema_org_specialty":null,"all":[{"code":"261QP2000X","description":"Physical Therapy Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"104 MAULDIN RD STE B","city":"GREENVILLE","state":"SC","postal_code":"296051221","country_code":"US","phone":"8642146680","fax":"8643098043"},{"purpose":"MAILING","street_1":"104 MAULDIN RD STE B","city":"GREENVILLE","state":"SC","postal_code":"296051221","country_code":"US","phone":"8642146680","fax":"8643098043"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20230130000319","type_code":"12-65","type_desc":"PART B SUPPLIER - PHYSICAL/OCCUPATIONAL THERAPY GROUP IN PRIVATE PRACTICE","state":"SC","pac_id":"5597136507"}]},"enumeration_date":"2022-10-10","last_updated":"2026-06-02","_meta":{"source":"NPPES","snapshot_date":"2026-06-02","doc_url":"https://findmynpi.com/api"}}