Active NPI
Heather McDonnell
- Physical Therapy Assistant
- Miller, SD
National Provider Identifier
1235822776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 97
- Practice address
- 300 W 5TH St
Miller, SD 57362-1238 - Phone
- (605) 852-2910
- Fax
- (605) 852-2757
- NPI assigned
- May 31, 2023
- Last updated
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 97 | SD | Primary |
Addresses
Primary practice location
300 W 5TH St
Miller, SD 57362-1238
Mailing address
PO Box 62
Highmore, SD 57345-0062
Phone (605) 870-1244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97 | SD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1235822776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62",
"city": "HIGHMORE",
"state": "SD",
"postal_code": "573450062",
"telephone_number": "605-870-1244",
"fax_number": "605-852-2757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 5TH ST",
"city": "MILLER",
"state": "SD",
"postal_code": "573621238",
"telephone_number": "605-852-2910",
"fax_number": "605-852-2757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONNELL",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SD",
"license": "97",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miller, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.