Individual provider Active NPI

Janeil M Heaton, M.P.T.

  • Specialist
  • Fruitland, ID
National Provider Identifier
1245205665
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT1882 Issued in ID
Practice address
215 N Whitley Dr
Suite 1
Fruitland, ID 83619-2705
Phone
(208) 452-6366
Fax
(208) 452-6399
NPI assigned
Feb 20, 2006
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT1882 ID Primary

Addresses

Primary practice location

215 N Whitley Dr
Suite 1
Fruitland, ID 83619-2705

Mailing address

215 N Whitley Dr
Suite 1
Fruitland, ID 83619-2705
Phone (208) 452-6366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040902001435 ID Practitioner - Physical Therapist in Private Practice 8820064660 Reassigns benefits to 1 organization
I20210212002178 WY Practitioner - Physical Therapist in Private Practice 8820064660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
In Motion Physical Therapy LLCGroup PAC ID 3274869847, 4 clinicians

Practice addresses (Care Compare)

501 Ctr St
Rock Springs, WY 82901-5105
Phone (307) 382-8661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT1882IDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Physical Therapy, P.C. Specialist CurrentSince May 24, 2004 Accepting new patients
In Motion Physical Therapy LLC CurrentSince Dec 1, 2020 Accepting new patients
Tri-City Physical Therapy, P.C. Specialist CurrentSince May 24, 2004 Accepting new patients

Locations

215 N Whitley Dr
Ste 1
Fruitland, ID 83619
Phone (208) 452-6366

275 E 7th St
Weiser, ID 83672
Phone (208) 549-1008

501 Center St
Rock Springs, WY 82901
Phone (307) 382-8661

617 Broadway St
Ste C
Rock Springs, WY 82901
Phone (307) 382-8661

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

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1245205665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N WHITLEY DR",
            "address_2": "SUITE 1",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192705",
            "telephone_number": "208-452-6366",
            "fax_number": "208-452-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N WHITLEY DR",
            "address_2": "SUITE 1",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192705",
            "telephone_number": "208-452-6366",
            "fax_number": "208-452-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "JANEIL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "PT1882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.