Heather Detwiler, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3288 Issued in SC

Practice address

2705 Leaphart Rd.
Carolina Gardens
West Columbia, SC 29169

Phone

(803) 939-3000

NPI assigned

Mar 16, 2017

Last updated

Mar 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1740721232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SWAINSON CT",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637808",
            "telephone_number": "803-361-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 LEAPHART RD.",
            "address_2": "CAROLINA GARDENS",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-939-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "HEATHER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentists of West Columbia, PC (Dentists of West Columbia)
• John D. Deperi, M. D.
• Jeffrey Scott Derenzo, DPT
• Kessler Derrrick, PHARMD
• Robert L. Deters, MD
• Karen Ann Devereaux, COTA
• Kristin K Devito, PA
• Jackara Shadasha Dewalt
• Raymond E Diamond, DO
• Angela Diaz, RN

• Physical Therapy Assistant in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.