NPIMap

Organization Active NPI

Heritage Enterprises, Inc

Doing business as Green Tree Therapy

  • Physical Therapy Clinic/Center
  • Bloomington, IL
National Provider Identifier
1104236165
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
HERITAGE ENTERPRISES, INC
Doing business as
Green Tree Therapy
Practice address
700 E Walnut St
Bloomington, IL 61701-3244
Phone
(309) 829-1268
Fax
(309) 829-3475
NPI assigned
Apr 30, 2014
Last updated
Apr 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
David M Underwood
Title
Sr VP & Cfo
Phone
(309) 823-7135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

700 E Walnut St
Bloomington, IL 61701-3244

Mailing address

115 W Jefferson St
Suite 401
Bloomington, IL 61701-3946
Phone (309) 823-7139

Other names 1

  • Green Tree Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heritage Enterprises Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1104236165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W JEFFERSON ST",
            "address_2": "SUITE 401",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013946",
            "telephone_number": "309-823-7139",
            "fax_number": "309-829-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013244",
            "telephone_number": "309-829-1268",
            "fax_number": "309-829-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP & CFO",
        "authorized_official_telephone_number": "309-823-7135"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Tree Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.