NPIMap

Organization Active NPI

Hetherington Therapy

  • Clinic/Center
  • Palm Bay, FL
National Provider Identifier
1235796228
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HETHERINGTON THERAPY
Practice address
1634 Saladino St SE
Palm Bay, FL 32909-5425
Phone
(833) 684-5429
NPI assigned
May 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Authorized official

Name
Mr. Nickolas Hetherington, MOT, OTR/L, CIMI-IINPI 1467804278
Title
Owner
Phone
(989) 450-6441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1634 Saladino St SE
Palm Bay, FL 32909-5425

Mailing address

1634 Saladino St SE
Palm Bay, FL 32909-5425
Phone (833) 684-5429

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1235796228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 SALADINO ST SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095425",
            "telephone_number": "833-684-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 SALADINO ST SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329095425",
            "telephone_number": "833-684-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HETHERINGTON THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-24",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "HETHERINGTON",
        "authorized_official_first_name": "NICKOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-450-6441",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MOT, OTR/L, CIMI-II"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.