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

Last updated

Jul 10, 2020By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Idaho Sport Massage LLC

  dba Idaho Sport Massage

  • 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 Hospice)
• 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

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• 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.