Individual provider Active NPI

Heather Girges, PT, DPT

  • Physical Therapist
  • Shelton, CT
National Provider Identifier
1255760930
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11599 Issued in CT
Practice address
555 Bridgeport Ave Ste 1
Shelton, CT 06484-4731
Phone
(203) 922-1773
Fax
(203) 924-2334
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01521000 NJ
Physical Therapist 225100000X 11599 CT Primary

Addresses

Primary practice location

555 Bridgeport Ave Ste 1
Shelton, CT 06484-4731

Mailing address

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

Other names 1

  • Heather Mickeal Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11599CTMDPhysical Therapist
40QA01521000NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1255760930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253506",
            "telephone_number": "203-384-8681",
            "fax_number": "203-384-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BRIDGEPORT AVE STE 1",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844731",
            "telephone_number": "203-922-1773",
            "fax_number": "203-924-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRGES",
        "first_name": "HEATHER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01521000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "11599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MICKEAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.