Individual provider Active NPI

Gabrielle Stubblefield Heinz, PT, DPT, ATC

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1053036251
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013798A Issued in IN
Practice address
14455 Clay Terrace Blvd
Carmel, IN 46032-3605
Phone
(317) 415-5747
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36002869A IN
Physical Therapist 225100000X 05013798A IN Primary

Addresses

Primary practice location

14455 Clay Terrace Blvd
Carmel, IN 46032-3605

Mailing address

14455 Clay Terrace Blvd
Carmel, IN 46032-3605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228001652 IN Practitioner - Physical Therapist in Private Practice 6901276450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14455 Clay Terrace Blvd
Carmel, IN 46032-3605
Phone (317) 415-5795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36002869AINMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Oct 17, 2022 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Oct 17, 2022 Accepting new patients
Saint Vincent Physician Services, Inc. Past Accepting new patients

Locations

14455 Clay Terrace Blvd
Ste B
Carmel, IN 46032
Phone (317) 415-5747

14455 Clay Terrace Blvd
Carmel, IN 46032
Phone (317) 415-5747

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

Interoperability endpoints

  • Direct secure messaging: gabrielle.heinz.1@7598.direct.athenahealth.com

Organizations & group practices 3

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1053036251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14455 CLAY TERRACE BLVD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14455 CLAY TERRACE BLVD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323605",
            "telephone_number": "317-415-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "GABRIELLE",
        "middle_name": "STUBBLEFIELD",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002869A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013798A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.