Individual provider Active NPI

Heather L. Wolf, P.A.

  • Medical Physician Assistant
  • Daniel Island, SC
National Provider Identifier
1801824511
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1820 Issued in SC
Practice address
225 Seven Farms Dr Ste 105
Daniel Island, SC 29492-8353
Phone
(843) 971-4460
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1820 SC Primary

Addresses

Primary practice location

225 Seven Farms Dr Ste 105
Daniel Island, SC 29492-8353

Mailing address

225 Seven Farms Dr Ste 105
Daniel Island, SC 29492-8353
Phone (843) 971-4460

Other practice location 1

814 E Woodland Ave
Knoxville, TN 37917-5648
Phone (865) 524-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121023000724 SC Practitioner - Physician Assistant 5799884953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Park Dermatology LLCGroup PAC ID 8820453137, 2 clinicians

Practice addresses (Care Compare)

109 River Landing Dr
Suite 400
Daniel Island, SC 29492-7300
Phone (843) 990-4511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1295TNMDSpeech-Language Pathologist
1820SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Island Park Dermatology LLC CurrentSince Mar 1, 2026 Accepting new patients

Locations

109 River Landing Dr
Ste 400
Daniel Island, SC 29492
Phone (843) 469-5641

Organizations & group practices 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1801824511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 SEVEN FARMS DR STE 105",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294928353",
            "telephone_number": "843-971-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SEVEN FARMS DR STE 105",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294928353",
            "telephone_number": "843-971-4460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "814 E Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175648",
            "country_code": "US",
            "telephone_number": "865-524-7107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "HEATHER",
        "middle_name": "L.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daniel Island, SC

Sources for this page

Verify at the official NPI Registry.