Heather Nicole Bohrisch, PTA, LMT, BCTMB

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-014565 Issued in AZ

Practice address

12833 W Orange Dr
Litchfield Park, AZ 85340-4102

Phone

(818) 661-0867

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Day-Neutill Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1275125437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12833 W ORANGE DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404102",
            "telephone_number": "818-661-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12833 W ORANGE DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404102",
            "telephone_number": "818-661-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHRISCH",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "PTA, LMT, BCTMB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-26863",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-014565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "DAY-NEUTILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.