Individual provider Active NPI

Kyle Thomas Heimer, D.C.

  • Chiropractor
  • Summerville, SC
National Provider Identifier
1013462837
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4089 Issued in SC
Practice address
1203 F Old Trolley Rd
Suite B
Summerville, SC 29485-5296
Phone
(843) 486-0999
Fax
(843) 486-0989
NPI assigned
Aug 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4089 SC Primary

Addresses

Primary practice location

1203 F Old Trolley Rd
Suite B
Summerville, SC 29485-5296

Mailing address

1203 F Old Trolley Rd
Suite B
Summerville, SC 29485-5296
Phone (843) 486-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161229001157 SC Practitioner - Chiropractic 1153602305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation Family Chiropractic, LLCGroup PAC ID 8921366394, 4 clinicians
Foundation Family Chiropractic SC LLCGroup PAC ID 8628517935, 2 clinicians

Practice addresses (Care Compare)

455 Old Trolley Rd
Suite a
Summerville, SC 29485-5669
Phone (843) 851-2417

617 Myers Rd
Suite G
Summerville, SC 29486-8902
Phone (843) 851-2417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4089SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Family Chiropractic SC, LLC Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
Foundation Family Chiropractic of Mount Pleasant Chiropractor Current Accepting new patients
Foundation Family Chiropractic, LLC Chiropractor CurrentSince Aug 13, 2016 Accepting new patients

Locations

455 Old Trolley Rd
Ste A
Summerville, SC 29485
Phone (843) 851-2417

617 Myers Rd
Ste G
Summerville, SC 29486
Phone (843) 851-2417

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1013462837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 F OLD TROLLEY RD",
            "address_2": "SUITE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855296",
            "telephone_number": "843-486-0999",
            "fax_number": "843-486-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 F OLD TROLLEY RD",
            "address_2": "SUITE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855296",
            "telephone_number": "843-486-0999",
            "fax_number": "843-486-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMER",
        "first_name": "KYLE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.