Individual provider Active NPI

Kristin L Heter

  • Physical Therapist
  • North Myrtle Beach, SC
National Provider Identifier
1194782920
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9372 Issued in SC
Practice address
1424 Highway 17 N Ste 2
North Myrtle Beach, SC 29582-2507
Phone
(843) 427-7132
Fax
(843) 427-7154
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32683 CA
Physical Therapist 225100000X P14185 NC
Physical Therapist 225100000X 9372 SC Primary

Addresses

Primary practice location

1424 Highway 17 N Ste 2
North Myrtle Beach, SC 29582-2507

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 682-8840

Other practice location 1

902 N Howe St
Southport, NC 28461-3038
Phone (910) 457-4789

Other practice location 2

6278 Beach Dr SW Ste 114
Ocean Isle Beach, NC 28469-3670
Phone (910) 579-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130628000262 NC Practitioner - Physical Therapist in Private Practice 1254500655 Reassigns benefits to 2 organizations
I20190107001169 SC Practitioner - Physical Therapist in Private Practice 1254500655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

1424 Hwy 17 N
Suite 2
North Myrtle Beach, SC 29582-2507
Phone (843) 427-7132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9372SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist Current Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Oct 10, 2018 Accepting new patients
Emergeortho PA CurrentSince Jul 1, 2016 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Apr 2, 2018 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist Current Accepting new patients
Emergeortho PA Physical Therapist CurrentSince Jul 1, 2016 Accepting new patients
Benchmark Health Services, LLC Physical Therapist CurrentSince Oct 10, 2018 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Apr 2, 2018 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2819 Midway Rd SE
Ste 114
Bolivia, NC 28422
Phone (910) 253-6930

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

6278 Beach Dr SW
Ste 114
Ocean Isle Beach, NC 28469
Phone (910) 579-3900

902 N Howe St
Southport, NC 28461
Phone (910) 457-4789

3787 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 341-2444

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7955 N Kings Hwy
Ste 330
Myrtle Beach, SC 29572
Phone (843) 945-1815

1424 Highway 17 N
Unit 2
North Myrtle Beach, SC 29582
Phone (843) 427-7132

Organizations & group practices 8

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1194782920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840",
            "fax_number": "423-602-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 HIGHWAY 17 N STE 2",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822507",
            "telephone_number": "843-427-7132",
            "fax_number": "843-427-7154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N Howe St",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284613038",
            "country_code": "US",
            "telephone_number": "910-457-4789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6278 Beach Dr SW Ste 114",
            "address_purpose": "LOCATION",
            "city": "Ocean Isle Beach",
            "state": "NC",
            "postal_code": "284693670",
            "country_code": "US",
            "telephone_number": "910-579-3900",
            "fax_number": "910-579-3905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETER",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "32683",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P14185",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.