Active NPI
Alisa Heronema, OTR/L, OTD
- Occupational Therapist
- Denver, CO
National Provider Identifier
1033568985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0004231
- Practice address
- 777 Bannock St
Denver, CO 80204-4507 - Phone
- (303) 436-6000
- NPI assigned
- Jun 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0004231 | CO | Primary |
Addresses
Primary practice location
777 Bannock St
Denver, CO 80204-4507
Mailing address
4699 Kittredge St
Unit 624
Denver, CO 80239-5752
Phone (970) 214-4043
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0004231 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1033568985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4699 KITTREDGE ST",
"address_2": "UNIT 624",
"city": "DENVER",
"state": "CO",
"postal_code": "802395752",
"telephone_number": "970-214-4043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044507",
"telephone_number": "303-436-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERONEMA",
"first_name": "ALISA",
"credential": "OTR/L, OTD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "0004231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.