Active NPI
Philip W Heagerty, LSW
- Social Worker
- Dover, OH
National Provider Identifier
1053522706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S0009397
- Practice address
- 201 Hospital Dr
Dover, OH 44622-2058 - Phone
- (330) 343-6631
- Fax
- (330) 343-8188
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S0009397 | OH | Primary |
Addresses
Primary practice location
201 Hospital Dr
Dover, OH 44622-2058
Mailing address
201 Hospital Dr
Dover, OH 44622-2058
Phone (330) 343-6631
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
| License | State | Type | Specialty |
|---|---|---|---|
| S0009397 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053522706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 HOSPITAL DR",
"city": "DOVER",
"state": "OH",
"postal_code": "446222058",
"telephone_number": "330-343-6631",
"fax_number": "330-343-8188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 HOSPITAL DR",
"city": "DOVER",
"state": "OH",
"postal_code": "446222058",
"telephone_number": "330-343-6631",
"fax_number": "330-343-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEAGERTY",
"first_name": "PHILIP",
"middle_name": "W",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S0009397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.