Mary M Heckel, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1046 Issued in ID

Practice address

448 S Maple Grove Road
Boise, ID 83709

Phone

(208) 859-9953

Fax

(208) 629-3155

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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)

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.

• Relax a Back Bodyworks LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1558381160
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124170121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 YORGASON WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033146",
            "telephone_number": "208-859-9953",
            "fax_number": "208-629-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 S MAPLE GROVE ROAD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-859-9953",
            "fax_number": "208-629-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKEL",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "TA484",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010148543",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecilee Heath, LCSW
• Heather K Dunnam LCSW PLLC
• Bren A Heaton, MD
• Kaye Heazle, RD, CSO, LD
• James HD Hecht, LPN
• Andi Hedges, PA-C
• Amy Elisa Hedrick, LCPC, CST
• Jill M Hedt
• Patricia R Heeb, LMFT
• Richard Heemeyer, DMD

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• 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.