Blue Heron Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1495 Issued in AZ

Legal business name

BLUE HERON PHYSICAL THERAPY PC

Practice address

3708 E Ripple Rd
Camp Verde, AZ 86322-8102

Phone

(212) 947-7039

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Mary Kathleen SawertNPI 1477617983

Title

President

Phone

(212) 947-7039

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Kathleen Sawert, P.T.

  • Physical Therapist
  • Camp Verde, AZ
  • NPI 1477617983
  NPD (past) Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144384652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 E RIPPLE RD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863228102",
            "telephone_number": "212-947-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 E RIPPLE RD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863228102",
            "telephone_number": "212-947-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HERON PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAWERT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-947-7039"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "1495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Haleh Bazargan, DDS
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• Diane April Bowlus, OT/L
• Daniel Briggs
• Paul Brncik Jr.
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• Physical Therapist in Camp Verde, AZ
• Providers in Camp Verde, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.