Individual provider Active NPI

Matthew Eric Heller, OTA

  • Occupational Therapy Assistant
  • Henderson, NV
National Provider Identifier
1235977216
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA3418 Issued in NV
Practice address
100 Delmar Gardens Dr
Henderson, NV 89074-3216
Phone
(702) 361-6111
NPI assigned
Jul 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA3418 NV Primary

Addresses

Primary practice location

100 Delmar Gardens Dr
Henderson, NV 89074-3216

Mailing address

5175 Jerry Tarkanian Way Unit 21106
Las Vegas, NV 89148-0015
Phone (858) 945-4366

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

LicenseStateTypeSpecialty
OTA3418NVMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1235977216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 JERRY TARKANIAN WAY UNIT 21106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891480015",
            "telephone_number": "858-945-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DELMAR GARDENS DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890743216",
            "telephone_number": "702-361-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "MATTHEW",
        "middle_name": "ERIC",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "OTA3418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.