Thomas Arthur Dehaven, DPT
Individual provider Active NPI Physical Therapist · Cayce, SC
NPI 1386236552 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1386236552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10531 (SC)
- Practice address
- 1105 12TH St
Cayce, SC 29033-3304 - Phone
- (803) 973-0100
- Fax
- (803) 973-0117
- NPI assigned
- Feb 9, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vertex PT Specialists LLC
Practice addresses (Care Compare)
1105 12TH St
Cayce, SC 29033-3304
Phone (803) 973-0100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210402000715 | SC | Practitioner - Physical Therapist in Private Practice | 5092122366 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10531 | SC | MD | Geriatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vertex PT Specialists, LLC | Physical Therapist | Current |
Accepting new patients |
| Lexington Health Inc | Current |
Accepting new patients | |
| Lexington Health Inc | Current |
Accepting new patients | |
| Lexington Health Inc | Current | Accepting new patients |
Locations
1105 12th St
Cayce, SC 29033
Phone (803) 973-0100
3799 12th Street Ext
Ste 100
Cayce, SC 29033
Phone (803) 926-6810
1825 Laurel St
Columbia, SC 29201
Phone (803) 851-3506
811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230
3799 12th Street Ext
Ste 110
West Columbia, SC 29033
Phone (803) 755-3337
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10531 | SC | Yes |
Addresses
Primary practice location
1105 12TH St
Cayce, SC 29033-3304
Mailing address
1105 12TH St
Cayce, SC 29033-3304
Phone (803) 973-0100
Other providers in Cayce, SC
- Judith Crocker-Billingsley
- Kilian John Daughtry
- Kya Coreisa Davis
- Marvin Linfred Davis
- Megan Joyner Davison
- Paw Der
- Melissa Anne Derrenbacher
- Arianna Derrick- Jones
- Doctors Care SC, PA
- Virginia Dorn
All providers in Cayce, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.