Individual provider Active NPI

Heather Putnam Oliver, APRN

  • Family Nurse Practitioner
  • Moore, SC
National Provider Identifier
1073932646
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18739 Issued in SC
Practice address
5895 Reidville Rd
Moore, SC 29369-8409
Phone
(864) 486-6990
NPI assigned
Apr 10, 2014
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18739 SC Primary

Addresses

Primary practice location

5895 Reidville Rd
Moore, SC 29369-8409

Mailing address

331 S High Point Rd
Spartanburg, SC 29301-3007
Phone (864) 680-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627001608 SC Practitioner - Nurse Practitioner 5294950655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of SC PCGroup PAC ID 4284864372, 32 clinicians

Practice addresses (Care Compare)

1650 Skylyn Dr
Suite 402
Spartanburg, SC 29307-1086
Phone (864) 574-0017

Merit-based Incentive Payment System (MIPS)

Final score
83.24 of 100Reported as group
Quality
80.28
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18739SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of SC PC CurrentSince Oct 10, 2016 Accepting new patients

Locations

1650 Skylyn Dr
Ste 402
Spartanburg, SC 29307
Phone (864) 574-0017

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1073932646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 S HIGH POINT RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013007",
            "telephone_number": "864-680-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 REIDVILLE RD",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293698409",
            "telephone_number": "864-486-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "HEATHER",
        "middle_name": "PUTNAM",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, SC

Sources for this page

Verify at the official NPI Registry.