Bryan Heiderscheit, P.T., PH.D.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4896-024 Issued in WI

Practice address

621 Science Dr
Uw Sports Rehabilitation
Madison, WI 53711-1074

Phone

(608) 263-4765

NPI assigned

May 25, 2007

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Des Moines University Osteopathic Medical Center

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1164475760

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114138732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SCIENCE DR",
            "address_2": "UW SPORTS REHABILITATION",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111074",
            "telephone_number": "608-263-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SCIENCE DR",
            "address_2": "UW SPORTS REHABILITATION",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111074",
            "telephone_number": "608-263-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDERSCHEIT",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "P.T., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4896-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "4896-024",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Afshin Heidari, M.D.
• Randy S Heidel, MD
• Brenda Lynn Heideman, LCSW
• Lynn M Heidemann, RN
• Frederick A Heiden, DO
• George Heidrich III, RN
• Jayson Heier, O.D.
• William R Heifner, MD
• Susan Margaret Heighway, M.S., APRN, BC
• Eric Heiligenstein, M.D.

• Physical Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Physical Therapist in Wisconsin

• 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.

Verify at the official NPI Registry.