Individual provider Active NPI

Heather Ann Thornsberry, PT/DPT

  • Physical Therapist
  • Corbin, KY
National Provider Identifier
1013047570
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002959 Issued in KY
Practice address
383 Corbin Center Drive
Corbin, KY 40701
Phone
(606) 526-2919
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 002959 KY Primary

Addresses

Primary practice location

383 Corbin Center Drive
Corbin, KY 40701

Mailing address

218 Outre Street
Tazewell, VA 24651
Phone (276) 832-1154

Other identifiers 1

IdentifierTypeStateIssuer
87029591MedicaidKY

Other names 1

  • Heather Watts 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

State licenses

LicenseStateTypeSpecialty
002959KYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1013047570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 OUTRE STREET",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "24651",
            "telephone_number": "276-832-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 CORBIN CENTER DRIVE",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40701",
            "telephone_number": "606-526-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNSBERRY",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "PT/DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "002959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87029591",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WATTS",
            "credential": "PT/DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.