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HEATHER HIGHSMITH MD
NPI 1053847889
Family Medicine in Greenwood, SC

Active since May 11, 2017PECOS EnrolledAccepts Medicare Assignment
96.08/100
CMS Quality Rating
155 ACADEMY AVE, GREENWOOD, SC 29646(864) 725-4865(864) 725-4883 Get Directions Write a Review

NPPES record last updated: May 22, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 22, 2019, Feb 4, 2019, May 11, 2017 (3 updates tracked since 2017).

About Heather Highsmith Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHER HIGHSMITH MD (NPI 1053847889) is an individual family medicine provider in Greenwood, South Carolina, licensed in South Carolina (41093) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, is affiliated with Piedmont Augusta Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1053847889
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameHEATHER HIGHSMITHCredential: MD
Location Address155 ACADEMY AVEGreenwood, SC 29646-3869
Mailing Address155 Academy AveGreenwood, SC 29646-3869 · (864) 725-4865 · Fax (864) 725-4883
Phone(864) 725-4865
Fax(864) 725-4883
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMay 11, 2017
Last NPPES UpdateMay 22, 20193 updates tracked since enumeration
✔ NPI 1053847889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 41093
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
155 ACADEMY AVE, Greenwood, SC 29646
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Heather Highsmith Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264787464
PECOS Enrollment IDI20180612000312
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Heather Highsmith reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Self Medical Group
Same address
Physical Medicine & Rehabilitation
115 ACADEMY AVENUE, UNIT A
Greenwood, SC 29646
  • Reassigned Medicare billing, South Carolina enrollment
  • 560 clinicians in this Medicare group
NPI 1134442890 (864) 725-7272
Self Regional Healthcare Partners
30 mi
Family Medicine
155 RIDGE MEDICAL PLAZA RD
Edgefield, SC 29824
  • Reassigned Medicare billing, South Carolina enrollment
  • Also billed through NPI 1922582105 (South Carolina)
  • 126 clinicians in this Medicare group
NPI 1053929208 (803) 637-3146

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
30 services16 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
18 services15 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Augusta Hospital

Acute Care Hospitals · Augusta, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110028
Location1350 Walton WayAugusta, GA 30901 · Richmond County
Emergency services Birthing friendly

Au Medical Center

Acute Care Hospitals · Augusta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110034
Location1120 15th StreetAugusta, GA 30912 · Richmond County
Emergency services Birthing friendly

Self Regional Healthcare

Acute Care Hospitals · Greenwood, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420071
Location1325 Spring StreetGreenwood, SC 29646 · Greenwood County
Emergency services Birthing friendly

Aiken Regional Medical Center

Acute Care Hospitals · Aiken, SC
2/5 CMS rating
OwnershipProprietary
CMS Certification Number420082
Location302 University ParkwayAiken, SC 29801 · Aiken County
Emergency services Birthing friendly

Edgefield County Healthcare An Affiliate Of Self R

Critical Access Hospitals · Edgefield, SC
OwnershipGovernment - Local
CMS Certification Number421304
Location300 Ridge Medical PlazaEdgefield, SC 29824 · Edgefield County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29646 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.08/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality92.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers16 claims32 services$5.76 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAITH BROWN
Student in an Organized Health Care Education/Training Program
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4869
HAL TANNER
Student in an Organized Health Care Education/Training Program
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865
LAUREN F HEARN DO
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865
HARVEY FLOYD HATCHER MD
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865
ANDREW SMITH MD
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865
BENJAMIN VELKY MD
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4869
JOY CAROLINE DRAPER M.D.
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865
NATHAN SMITH MD
Family Medicine
155 ACADEMY AVE
GREENWOOD, SC 29646
Greenwood County (864) 725-4865

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heather Highsmith's NPI number?

The NPI number for Heather Highsmith is 1053847889. It was assigned to this individual provider in the NPPES registry on May 11, 2017.

Where is Heather Highsmith located?

Heather Highsmith practices at 155 Academy Ave, Greenwood, SC 29646. The listed phone number is (864) 725-4865.

What is Heather Highsmith's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Heather Highsmith enrolled in Medicare?

Yes. Heather Highsmith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Heather Highsmith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Heather Highsmith reassigns Medicare benefits to 2 organizations: Self Medical Group (Greenwood, SC) and Self Regional Healthcare Partners (Edgefield, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Heather Highsmith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Heather Highsmith accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next list Heather Highsmith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Heather Highsmith affiliated with any hospitals?

According to CMS data, Heather Highsmith is affiliated with Piedmont Augusta Hospital, Au Medical Center, Self Regional Healthcare, Aiken Regional Medical Center and Edgefield County Healthcare An Affiliate Of Self R.

When was this NPI record last updated?

The NPPES record for Heather Highsmith was last updated on May 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.