Individual provider Active NPI

Heaven Powell

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1164807293
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7868 Issued in SC
Practice address
1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476
Phone
(843) 521-1970
Fax
(843) 521-0908
NPI assigned
Jul 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7868 SC Primary

Addresses

Primary practice location

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476

Mailing address

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5476
Phone (843) 521-1970

Other identifiers 1

IdentifierTypeStateIssuer
7868OtherSCLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014001485 SC Practitioner - Physical Therapist in Private Practice 3072822006 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaufort Orthopaedic Sports and Spine Center LLCGroup PAC ID 1355301771, 48 clinicians

Practice addresses (Care Compare)

1076 Ribaut Rd
Suite 102
Beaufort, SC 29902-5490
Phone (843) 379-0836

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
57.41
Promoting interoperability
100
Improvement activities
40
Cost
80.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Aug 1, 2024 Accepting new patients
Carolina Sportscare and Physical Therapy Physical Therapist CurrentSince Sep 1, 2015 Accepting new patients
Total Joint and Orthopedic Physical Therapy Physical Therapist CurrentSince Mar 4, 2024 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

1076 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 521-1970

1076 Ribaut Rd
Ste 101
Beaufort, SC 29902
Phone (843) 525-0045

1900 Boundary St
Ste 101
Beaufort, SC 29902
Phone (843) 521-1970

Organizations & group practices 4

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1164807293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "SUITE 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025476",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "SUITE 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025476",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "HEAVEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7868",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.