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

Jordan Kimball

Individual provider Physical Therapist · NPI 1417696535

Jordan Kimball is a Physical Therapist in Private Practice in Fort Mill, South Carolina. Qualified in 2022, 4 years ago. Practices with Ivyrehab Focus, Inc, a 40-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Iowa, North Carolina and South Carolina.

Years since qualifying
4
Licensed in
IA, NC, SC
In the registry since
2022
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

130 Crisanto Ave Ste A
Fort Mill, SC 29715-6272
Phone: (803) 746-4655
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3485 Windsor Ave, Dubuque, IA 52001-1329 — (563) 557-7180
  • 2100 N Davidson St Ste C, Charlotte, NC 28205-1828 — (980) 556-7780

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12276 (SC)
Physical Therapist Taxonomy 225100000X · Licence 114750 (IA)
Physical Therapist Taxonomy 225100000X · Licence P22943 (NC)

Record details

NPI number1417696535
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 27, 2022
Last updated in NPPESMarch 19, 2024
Certification dateMarch 19, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ivyrehab Focus, Inc. — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Mill