Individual provider Active NPI

Beth Heise, PT

  • Physical Therapist
  • Iowa City, IA
National Provider Identifier
1215064712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01275
Practice address
2401 Towncrest Dr
Iowa City, IA 52240-6631
Phone
(319) 354-2429
Fax
(319) 354-6100
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 01275 Primary

Addresses

Primary practice location

2401 Towncrest Dr
Iowa City, IA 52240-6631

Mailing address

2401 Towncrest Dr
Iowa City, IA 52240-6631
Phone (319) 354-2429

Other identifiers 1

IdentifierTypeStateIssuer
0665463MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190110003402 AZ Practitioner - Physical Therapist in Private Practice 7214273358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDM Physical Therapy LLCGroup PAC ID 8820242563, 5 clinicians

Practice addresses (Care Compare)

7205 E Southern Ave
Suite 111
Mesa, AZ 85209-2791
Phone (480) 832-9308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MDM Physical Therapy, LLC Physical Therapist CurrentSince Sep 7, 2018 Accepting new patients
Progressive Rehab Chiropractic, L.L.C. Past Accepting new patients
Progressive Rehabilitation Associates L.L.C. Physical Therapist Past Accepting new patients

Locations

7205 E Southern Ave
Ste 111
Mesa, AZ 85209
Phone (480) 832-9308

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215064712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 TOWNCREST DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406631",
            "telephone_number": "319-354-2429",
            "fax_number": "319-354-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 TOWNCREST DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406631",
            "telephone_number": "319-354-2429",
            "fax_number": "319-354-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISE",
        "first_name": "BETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "01275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.