Individual provider Active NPI

Amanda Heyboer, M.P.T.

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1457317836
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3876 Issued in SC
Practice address
8 Farmfield Ave
Suite B
Charleston, SC 29407-7779
Phone
(843) 266-9200
Fax
(843) 266-9201
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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 3876 SC Primary

Addresses

Primary practice location

8 Farmfield Ave
Suite B
Charleston, SC 29407-7779

Mailing address

8 Farmfield Ave
Suite B
Charleston, SC 29407-7779
Phone (843) 266-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040107000222 SC Practitioner - Physical Therapist in Private Practice 6103725353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8 Farmfield Ave
Suite B
Charleston, SC 29407-7779
Phone (843) 266-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3276SCMDGeneral Practice Dentistry
3876SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Physical Therapy Associates LLC Physical Therapist CurrentSince May 1, 2005 Accepting new patients
CBD Medical Enterprises PA Past Accepting new patients
Lowcountry Medical Associates Past Accepting new patients

Locations

8 Farmfield Ave
Ste B
Charleston, SC 29407
Phone (843) 266-9200

Organizations & group practices 3

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1457317836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FARMFIELD AVE",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077779",
            "telephone_number": "843-266-9200",
            "fax_number": "843-266-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FARMFIELD AVE",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077779",
            "telephone_number": "843-266-9200",
            "fax_number": "843-266-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYBOER",
        "first_name": "AMANDA",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.