Individual provider Active NPI

Kristi D Haley, DPT

  • Physical Therapist
  • Seneca, SC
National Provider Identifier
1386652899
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5094 Issued in SC
Practice address
135 Eagles Nest Park
Suite E
Seneca, SC 29678-2766
Phone
(864) 882-7965
Fax
(864) 882-7967
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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 5094 SC Primary

Addresses

Primary practice location

135 Eagles Nest Park
Suite E
Seneca, SC 29678-2766

Mailing address

135 Eagles Nest Park
Suite E
Seneca, SC 29678-2766
Phone (864) 882-7965

Other identifiers 1

IdentifierTypeStateIssuer
TH1648MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060925000563 SC Practitioner - Physical Therapist in Private Practice 3870598824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hummel Physical Therapy IncGroup PAC ID 7618870155, 2 clinicians

Practice addresses (Care Compare)

135 Eagles Nest Park
Suite E
Seneca, SC 29678-2766
Phone (864) 882-7965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5094SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hummel Physical Therapy Inc. Physical Therapist CurrentSince Jul 3, 2006 Accepting new patients

Locations

135 Eagles Nest Dr
Ste E
Seneca, SC 29678
Phone (864) 882-7965

135 Eagles Nest Dr
Seneca, SC 29678
Phone (864) 882-7965

Organizations & group practices 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1386652899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EAGLES NEST PARK",
            "address_2": "SUITE E",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782766",
            "telephone_number": "864-882-7965",
            "fax_number": "864-882-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAGLES NEST PARK",
            "address_2": "SUITE E",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782766",
            "telephone_number": "864-882-7965",
            "fax_number": "864-882-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "KRISTI",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1648",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.