Individual provider Active NPI

Heather Elizabeth Shiflett, PA-C

  • Physician Assistant
  • Fort Mill, SC
National Provider Identifier
1619901568
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102370 Issued in NC
Practice address
1040 Edgewater Corporate Pkwy Ste 104
Fort Mill, SC 29707-4526
Phone
(803) 547-8660
Fax
(704) 544-0172
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1328 SC
Physician Assistant 363A00000X 102370 NC Primary

Addresses

Primary practice location

1040 Edgewater Corporate Pkwy Ste 104
Fort Mill, SC 29707-4526

Mailing address

8015 Farmbrook Dr
Waxhaw, NC 28173-7123
Phone (704) 667-2650

Other practice location 1

197 Piedmont Blvd Ste 100
Rock Hill, SC 29732-1825
Phone (803) 324-1950

Other identifiers 3

IdentifierTypeStateIssuer
1619901568MedicaidNC
8102101MedicaidNC
1865PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050331000371 NC Practitioner - Physician Assistant 0648227884 Reassigns benefits to 2 organizations
I20140722001146 SC Practitioner - Physician Assistant 0648227884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

1000 Wellness Way
Fort Mill, SC 29715-7315
Phone (803) 802-3662

197 Piedmont Blvd
Rock Hill, SC 29732-1824
Phone (803) 324-1950

200 Herlong Ave S
Rock Hill, SC 29732-1182

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 324-1950

222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1328SCMDPhysical Therapist
102370NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Revlis Medical, LLC CurrentSince Mar 9, 2021 Accepting new patients
Carolinas Medical Center CurrentSince Sep 8, 2025 Accepting new patients
Waxhaw Medical Wellness, PLLC CurrentSince Feb 1, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Sep 8, 2025 Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Medical Center Past Accepting new patients
Piedmont General Surgery Associates, LLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Union Urgent Care LLC Past Accepting new patients

Locations

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1001 Blythe Blvd
Ste 300
Charlotte, NC 28203

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

16455 Statesville Rd
Ste 100
Huntersville, NC 28078
Phone (704) 801-1701

1040 Edgewater Corporate Pkwy
Ste 104
Indian Land, SC 29707
Phone (704) 557-0500

Interoperability endpoints

  • Direct secure messaging: heather.shiflett@356474464829444.direct.elationemr.com
  • Direct secure messaging: heather.shiflett.1@14929.direct.athenahealth.com
  • Direct secure messaging: hshiflett3030770@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1619901568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 FARMBROOK DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737123",
            "telephone_number": "704-667-2650",
            "fax_number": "704-544-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EDGEWATER CORPORATE PKWY STE 104",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297074526",
            "telephone_number": "803-547-8660",
            "fax_number": "704-544-0172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Piedmont Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321825",
            "country_code": "US",
            "telephone_number": "803-324-1950",
            "fax_number": "803-324-1933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIFLETT",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "1328",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619901568",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102101",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1865PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.