Provider Demographics
NPI:1821048299
Name:THOMPSON, JENNIFER RUSHER (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RUSHER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UPSTATE PHYSICAL THERAPY
Mailing Address - Street 2:120 MUTAL DR
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-261-3313
Mailing Address - Fax:864-261-3371
Practice Address - Street 1:UPSTATE PHYSICAL THERAPY OF ANDERSON. PA
Practice Address - Street 2:120 MUTAL DR
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:509-946-8497
Practice Address - Fax:509-946-8767
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPT4459225100000X
WAPT60605610225100000X
SCSC4459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0349713OtherWA L&I
WA1821048299Medicaid
WAG8948438Medicare PIN