Individual provider Active NPI

Anna Blair Henderson

  • Occupational Therapist
  • Mt Pleasant, SC
National Provider Identifier
1104227594
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1351 Fairmont Ave
Mt Pleasant, SC 29464-4456
Phone
(704) 534-4471
NPI assigned
Sep 4, 2014
Reactivated
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X SC Primary

Addresses

Primary practice location

1351 Fairmont Ave
Mt Pleasant, SC 29464-4456

Mailing address

1351 Fairmont Ave
Mt Pleasant, SC 29464-4456
Phone (704) 534-4471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141116000028 SC Practitioner - Occupational Therapist in Private Practice 4880816495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

1053 Ctr St
West Columbia, SC 29169-6749
Phone (800) 491-0909

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4360SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Jan 9, 2024 Accepting new patients
SC House Calls Inc CurrentSince Jan 9, 2024 Accepting new patients

Locations

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Organizations & group practices 2

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1104227594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 FAIRMONT AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644456",
            "telephone_number": "704-534-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 FAIRMONT AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644456",
            "telephone_number": "704-534-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANNA",
        "middle_name": "BLAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2024-01-30",
        "deactivation_date": "2016-04-06",
        "reactivation_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.