Provider Demographics
NPI:1740426527
Name:ROOPE, HEIDI (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:ROOPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:910 JOHNNIE DODDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3105
Mailing Address - Country:US
Mailing Address - Phone:843-606-0906
Mailing Address - Fax:
Practice Address - Street 1:910 JOHNNIE DODDS BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3105
Practice Address - Country:US
Practice Address - Phone:843-971-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-26
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35118225100000X
SC6938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ17431ZMedicare PIN