Imari Jeanine Heavens, PT,DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Practice address

12731 Marblestone Dr Ste 202
Woodbridge, VA 22192-8334

Phone

(571) 659-2612

NPI assigned

Aug 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Virginia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Fairfax, VA
  • NPI 1235720848

  DC, Orthopedic

  Medicare reassignment NPD
• Lake Ridge Physical Therapy, LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1871598417
  NPD (past)

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1043987795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12731 MARBLESTONE DR STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928334",
            "telephone_number": "571-659-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12731 MARBLESTONE DR STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928334",
            "telephone_number": "571-659-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVENS",
        "first_name": "IMARI",
        "middle_name": "JEANINE",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Ease Nutrition PLLC
• Healthlink Tranz LLC
• Healzy Ride LLC
• Heart and Vascular Institute of Virginia, Inc
• Heaven Divine Angels LLC
• Jane Elizabeth Heiertz, RN CPNP
• Cynthia L Heins, MD
• Helping Hands Family Virginia LLC
• Helping Hands Homecare Services of Northern Virginia
• Helpinghandshomecare Services of Northern Virginia

• Orthopedic Physical Therapist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Orthopedic Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.