Active NPI
Heather Jo Watson, PTA
- Physical Therapy Assistant
- Terre Haute, IN
National Provider Identifier
1124317896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06003752A
- Practice address
- 500 College Ave
Terre Haute, IN 47802-1139 - Phone
- (812) 917-2320
- Fax
- (812) 917-2320
- NPI assigned
- Apr 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06003752A | IN | Primary |
| Physical Therapy Assistant | 225200000X | 160.004994 | IL |
Addresses
Primary practice location
500 College Ave
Terre Haute, IN 47802-1139
Mailing address
500 College Ave
Terre Haute, IN 47802-1139
Phone (812) 917-2320
Other names 1
- Miss Heather Jo Hinesley
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 |
|---|---|---|---|
| 160.004994 | IL | MD | Physical Therapy Assistant |
| 06003752A | IN | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Past | Accepting new patients | |
| Legacy Healthcare Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Kokomo, IN
- NPI 1518069913
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301875200000",
"number": "1124317896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 COLLEGE AVE",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478021139",
"telephone_number": "812-917-2320",
"fax_number": "812-917-2320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 COLLEGE AVE",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478021139",
"telephone_number": "812-917-2320",
"fax_number": "812-917-2320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "HEATHER",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-04",
"last_updated": "2011-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06003752A",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.004994",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "HINESLEY",
"middle_name": "JO",
"prefix": "MISS",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.