Heather Lynn Wacksman, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2833 Issued in ME

Practice address

50 Forest Falls Dr
Suite 2
Yarmouth, ME 04096-6937

Phone

(207) 846-8725

Fax

(207) 846-8728

NPI assigned

Oct 10, 2006

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 5

Other names 1

• Miss Heather Lynn Harmon Former name

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.

• Jade Trade Inc.

  • Physical Therapist
  • Portland, ME
  • NPI 1578753836
  NPD (past)
• Optimal Performance Physical Therapy,LLC

  • Physical Therapist
  • Scarborough, ME
  • NPI 1518953959
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1154419653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARMON DR",
            "city": "STANDISH",
            "state": "ME",
            "postal_code": "040845451",
            "telephone_number": "207-240-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FOREST FALLS DR",
            "address_2": "SUITE 2",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966937",
            "telephone_number": "207-846-8725",
            "fax_number": "207-846-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKSMAN",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2756063001",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "626281",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "098997",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11507672",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432475009",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "HARMON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vacationland Care Group, LLC
• Jan Veinot, PH.D.
• Grace Violette-Hill, RDN
• Maryanne Vitalius, LCPC
• VK Yarmouth, LLC
• Walgreen Eastern Co Inc
• Corey Walmer, LCSW
• Stephen Walsh
• David Ward, LCSW
• Ryan W Weeks, DPT

• Physical Therapist in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.

Verify at the official NPI Registry.