Larry D Hinson, R.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6453 Issued in CA

Practice address

18661 Old Coast Hwy
Fort Bragg, CA 95437-8260

Phone

(707) 964-5645

Fax

(707) 964-6213

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hackley Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Fort Bragg, CA
  • NPI 1235316993
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1083617336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18661 OLD COAST HWY",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378260",
            "telephone_number": "707-964-5645",
            "fax_number": "707-964-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18661 OLD COAST HWY",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378260",
            "telephone_number": "707-964-5645",
            "fax_number": "707-964-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINSON",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "R.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA. STATE LICENSE NUMBER",
            "identifier": "PT6453",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0064530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry Ira Heiss, MD
• Waltraud Helma
• Breon Maree Henderson, RNC, MSN, CLC
• Suzanne H. Hewitt, FNP
• Anne Hill, ACSW
• Tiffany Hobbs
• Simon Hodson, MFT
• Dawn Barbara Hofberg, PA
• Grace Holldorf
• Ashley Marie Hood

• Physical Therapist in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.

Verify at the official NPI Registry.