Mary Katherine Campbell Heffernan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6652 Issued in SC

Practice address

1011 Grove Rd
Suite 2-a
Greenville, SC 29605-4660

Phone

(864) 233-5128

Fax

(864) 271-2599

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Katherine Olyvia Campbell Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Integrated Therapy Centers LLCGroup PAC ID 3274552716, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elite Integrated Therapy Centers, LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1184673600
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1548560691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 GROVE RD",
            "address_2": "SUITE 2-A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054660",
            "telephone_number": "864-233-5128",
            "fax_number": "864-271-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 GROVE RD",
            "address_2": "SUITE 2-A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054660",
            "telephone_number": "864-233-5128",
            "fax_number": "864-271-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "MARY KATHERINE",
        "middle_name": "CAMPBELL",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT25937",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY KATHERINE",
            "last_name": "CAMPBELL",
            "middle_name": "OLYVIA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phillip Lee Hedrick, ATC
• Kelly Heegard, M.D.
• Dawn Martin Heeke, RD, LD
• Marianne Butler Heeringa, RN
• Andrew Tyler Heffernan, M.D.
• Nathan Heffington, FNP-BC
• Ryan Christopher Hefty, PHARMD
• Amanda Marie Heidbreder, CRNA
• Magen Elizabeth Heide, MD
• Robert Allen James Heider, MD

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

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