Individual provider Active NPI

Richard D Heavner, DC

  • Chiropractor
  • Florence, SC
National Provider Identifier
1366443582
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2207 Issued in SC
Practice address
1501 Heritage LN
Florence, SC 29505-3141
Phone
(843) 665-7817
Fax
(843) 665-7928
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2207 SC Primary

Addresses

Primary practice location

1501 Heritage LN
Florence, SC 29505-3141

Mailing address

2234 W Palmetto St
Florence, SC 29501-4047
Phone (843) 665-7817

Other identifiers 1

IdentifierTypeStateIssuer
CH2207MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000102 SC Practitioner - Chiropractic 1557452760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2234 W Palmetto St
Florence, SC 29501-4047
Phone (843) 665-7817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9910SCMDSocial Worker
2207SCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health Chiropractic Center, LLC Chiropractor CurrentSince Nov 1, 2018 Accepting new patients
Eads Chiropractic Wellness Chiropractor Past Accepting new patients
Eads Chiropractic Wellness Centers Chiropractor PastSince Jun 1, 1999 Accepting new patients
Pee Dee Chiropractic Family Health Center Chiropractor Past Accepting new patients

Locations

1501 Heritage Ln
Florence, SC 29505
Phone (843) 665-6777

2234 W Palmetto St
Florence, SC 29501
Phone (843) 665-5505

2234 W Palmetto St
#A
Florence, SC 29501
Phone (843) 665-5505

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1366443582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 W PALMETTO ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014047",
            "telephone_number": "843-665-7817",
            "fax_number": "843-665-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HERITAGE LN",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053141",
            "telephone_number": "843-665-7817",
            "fax_number": "843-665-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVNER",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2207",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.