Individual provider Active NPI

Mike B Hearron, DPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1003236274
Registry record updated Jul 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60461336 Issued in WA
Practice address
1188 106TH Ave NE
Suite 100
Bellevue, WA 98004-8612
Phone
(425) 455-2630
Fax
(425) 451-4390
NPI assigned
Apr 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60461336 WA Primary

Addresses

Primary practice location

1188 106TH Ave NE
Suite 100
Bellevue, WA 98004-8612

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140725002362 WA Practitioner - Physical Therapist in Private Practice 1052537172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Group PCGroup PAC ID 0042111718, 192 clinicians

Practice addresses (Care Compare)

10207 19TH Ave SE
Everett, WA 98208-4257
Phone (425) 337-3166

4220 132ND St SE
Mill Creek, WA 98012-8999
Phone (425) 686-7655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 17, 2019 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 17, 2019 Accepting new patients

Locations

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

111 Market St NE
Ste 108
Olympia, WA 98501
Phone (360) 754-7085

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436659200000",
    "number": "1003236274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 106TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048612",
            "telephone_number": "425-455-2630",
            "fax_number": "425-451-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARRON",
        "first_name": "MIKE",
        "middle_name": "B",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-25",
        "last_updated": "2015-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60461336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2015; 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.