Individual provider Active NPI

Heidi Marie Epperson, MS

  • Pediatric Physical Therapist
  • Bentonville, AR
National Provider Identifier
1003856725
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT 1615 Issued in AR
Practice address
500 Tiger Blvd.
Bentonville, AR 72712
Phone
(479) 254-5065
Fax
(479) 271-1123
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT 1615 AR Primary

Addresses

Primary practice location

500 Tiger Blvd.
Bentonville, AR 72712

Mailing address

612 Chateau Dr.
Rogers, AR 72758-3936
Phone (479) 621-8180

Other identifiers 2

IdentifierTypeStateIssuer
126411721MedicaidAR
5U213OtherARBLUE CROSS

Other names 1

  • Heidi Marie Roberts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT 1615ARMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bentonville Public Schools Past Accepting new patients

Organizations & group practices 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1003856725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CHATEAU DR.",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727583936",
            "telephone_number": "479-621-8180",
            "fax_number": "479-621-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TIGER BLVD.",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-254-5065",
            "fax_number": "479-271-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AR",
            "license": "PT 1615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126411721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5U213",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "ROBERTS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.