Kristin E Bevilacqua, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7337 Issued in SC

Practice address

SC House Calls Inc.
111 Doctors Cir.
Columbia, SC 29203

Phone

(800) 491-0909

Fax

(843) 589-1585

NPI assigned

Jan 18, 2011

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

Other identifiers 2

Other names 1

• Kristin E Dougherty Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Temple University School of Medicine, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristin.bevilacqua.1@7602.direct.athenahealth.com

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.

• SC House Calls Inc

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1518048859

  SC

  Medicare reassignment Care Compare group NPD
• Fox Rehabilitation Services of South Carolina, LLC

  • Physical Therapist
  • Lexington, SC
  • NPI 1902133689
  Medicare reassignment NPD
• Progressive Rehabilitation Solutions LLC

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1669975496
  Medicare reassignment NPD
• SC House Calls Inc

  • Oxygen Equipment & Supplies (DME)
  • Columbia, SC
  • NPI 1073201711
  Care Compare group NPD

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1992000293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS INC.",
            "address_2": "111 DOCTORS CIR.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "800-491-0909",
            "fax_number": "843-589-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS INC.",
            "address_2": "111 DOCTORS CIR.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "800-491-0909",
            "fax_number": "843-589-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2024-02-15",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH3758",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9145",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DOUGHERTY",
            "middle_name": "E",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Columbia, SC
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.