Individual provider Active NPI

Thomas Arthur Dehaven, DPT

  • Physical Therapist
  • Cayce, SC
National Provider Identifier
1386236552
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10531 Issued in SC
Practice address
1105 12TH St
Cayce, SC 29033-3304
Phone
(803) 973-0100
Fax
(803) 973-0117
NPI assigned
Feb 9, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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 10531 SC Primary

Addresses

Primary practice location

1105 12TH St
Cayce, SC 29033-3304

Mailing address

1105 12TH St
Cayce, SC 29033-3304
Phone (803) 973-0100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210402000715 SC Practitioner - Physical Therapist in Private Practice 5092122366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 1355640285, 18 clinicians

Practice addresses (Care Compare)

1105 12TH St
Cayce, SC 29033-3304
Phone (803) 973-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10531SCMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vertex PT Specialists, LLC Physical Therapist CurrentSince Nov 8, 2021 Accepting new patients
Lexington Health Inc CurrentSince Feb 22, 2021 Accepting new patients
Lexington Health Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 22, 2021 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1386236552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 12TH ST",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333304",
            "telephone_number": "803-973-0100",
            "fax_number": "803-973-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 12TH ST",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333304",
            "telephone_number": "803-973-0100",
            "fax_number": "803-973-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "THOMAS",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.