MEDICARE: CORNERSTONE PELVIC HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1679437982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE PELVIC HEALTH LLC

Provider Business Mailing Address
First Line	:	909 STANDING SPRINGS RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29605-5924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 RIVERS AVE STE 100
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	864-404-6987
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	AMANDA NICOLE SHORTER
Credential	:	OTR/L
Telephone Number	:	864-404-6987

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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