Individual provider Active NPI

Heather Densmore, P.T.

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1154655066
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8070 Issued in NC
Practice address
136 Fairview Rd
Suite 110
Mooresville, NC 28117-9517
Phone
(704) 799-4611
NPI assigned
Sep 24, 2009
Last updated
Jul 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8070 NC Primary

Addresses

Primary practice location

136 Fairview Rd
Suite 110
Mooresville, NC 28117-9517

Mailing address

PO Box 4570
Davidson, NC 28036-4570
Phone (704) 819-6910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260526002262 NC Practitioner - Physical Therapist in Private Practice 0547730020 Reassigns benefits to 1 organization
Practice locations: Charlotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11111 Carmel Commons Blvd
Suite 350 B
Charlotte, NC 28226-0008
Phone (913) 814-2077

PO Box
Suite 1509
Louisville, KY 40201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8070NCMDOrthodontics and Dentofacial Orthopedic Dentist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1154655066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4570",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280364570",
            "telephone_number": "704-819-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 FAIRVIEW RD",
            "address_2": "SUITE 110",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179517",
            "telephone_number": "704-799-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENSMORE",
        "first_name": "HEATHER",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.