Dwinell L Heverly, BS OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1457 Issued in NM

Practice address

901 Douglas Ave
Las Vegas, NM 87701-3928

Phone

(505) 454-5700

Fax

(505) 454-5702

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Las Vegas City Schools

  • Local Education Agency (LEA)
  • Las Vegas, NM
  • NPI 1639203318
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285767400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILD FLOWER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019667",
            "telephone_number": "505-426-1753",
            "fax_number": "505-454-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOUGLAS AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877013928",
            "telephone_number": "505-454-5700",
            "fax_number": "505-454-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEVERLY",
        "first_name": "DWINELL",
        "middle_name": "L",
        "credential": "BS OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "1457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225X00000X",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.