Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Ryder Gray

Individual provider Physical Therapist · NPI 1447085022

Ethan Ryder Gray is a Physical Therapist in Private Practice in Travelers Rest, South Carolina. Qualified in 2024, 2 years ago. Practices with Greenville Proaxis Therapy LLC, a 222-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
2
Licensed in
SC
In the registry since
2024
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Practice location Address checks out

36 S Main St Ste B
Travelers Rest, SC 29690-1872
Phone: (864) 660-8200
Fax: (864) 660-8204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (SC)

Record details

NPI number1447085022
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2024
Last updated in NPPESSeptember 4, 2024
Certification dateSeptember 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Greenville Proaxis Therapy Llc — 222 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Travelers Rest