Individual provider Active NPI

Kimberly High Werts, O.T.

  • Occupational Therapist
  • Columbia, SC
National Provider Identifier
1528037603
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2067 Issued in SC
Practice address
1910 Blanding Street
Columbia, SC 29201
Phone
(803) 256-4107
Fax
(803) 253-6676
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2067 SC Primary

Addresses

Primary practice location

1910 Blanding Street
Columbia, SC 29201

Mailing address

1910 Blanding Street
Columbia, SC 29201
Phone (803) 256-4107

Other identifiers 1

IdentifierTypeStateIssuer
2067OtherSCOT LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120510000065 SC Practitioner - Occupational Therapist in Private Practice 6103088034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1013 Lake Murray Blvd
Irmo, SC 29063-2824
Phone (803) 256-4107

109 Park Place CT
Lexington, SC 29072-6690
Phone (803) 256-4107

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Mar 24, 2012 Accepting new patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Mar 24, 2012 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA Past Accepting new patients

Locations

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

1013 Lake Murray Blvd
Irmo, SC 29063
Phone (803) 732-5887

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1528037603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 BLANDING STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-256-4107",
            "fax_number": "803-253-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 BLANDING STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-256-4107",
            "fax_number": "803-253-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTS",
        "first_name": "KIMBERLY",
        "middle_name": "HIGH",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE #",
            "identifier": "2067",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.