Individual provider Active NPI

Anna Marie Heelan

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1649696162
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2077 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-8908
Phone
(843) 792-1414
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TL2077 SC
Physician Assistant 363A00000X 2077 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8908

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20140609002051 SC Practitioner - Physician Assistant 6608090808 Reassigns benefits to 2 organizations
I20200529002101 NC Practitioner - Physician Assistant 6608090808 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
The Neil Group IncGroup PAC ID 2365581196, 19 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

1399 Ashleybrook LN
Suite 100
Winston Salem, NC 27103-2961
Phone (336) 774-2194

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL2077SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Network CurrentSince Feb 17, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Feb 17, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Feb 17, 2020 Accepting new patients
Columbus Regional Health Network CurrentSince Feb 17, 2020 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Sep 15, 2016 Accepting new patients
Scotland Regional Health Network CurrentSince Feb 17, 2020 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Sep 15, 2016 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

10650 Park Rd
Ste 480
Charlotte, NC 28210
Phone (704) 355-1813

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

920 Church St N
Ste 255B
Concord, NC 28025
Phone (704) 403-1331

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

Interoperability endpoints

  • Direct secure messaging: aheelan386279@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1649696162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEELAN",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL2077",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.