Jonah Nicholas Heyneman, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6967 Issued in ID

Practice address

675 Yellowstone Ave # 1
Pocatello, ID 83201-4511

Phone

(208) 478-1488

NPI assigned

Jul 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Idaho Sport Massage LLC

  • Massage Therapist
  • Pocatello, ID
  • NPI 1932946332
  NPD

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1164040655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 PHEASANT RIDGE DR APT B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021689",
            "telephone_number": "208-852-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 YELLOWSTONE AVE # 1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014511",
            "telephone_number": "208-478-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYNEMAN",
        "first_name": "JONAH",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "6967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heritage Home Health LLC
• Heritage Home Health, LLC
• Heritage Physician and Resource Group LLC
• Daniel Herrera, B.A. R.C.
• Jessica Beth Hetcko, DDS
• Nicholas E. Heyneman, PHD
• Monte Cache Hibbert
• Logan D Higbee, PA-C
• Shawn R Higbee, DPT
• Justin Higgins, RN

• All providers in Pocatello, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.