Active NPI
Heather J Vivenzio, PT
- Pediatric Physical Therapist
- Bedford, NH
National Provider Identifier
1316936255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2299
- Practice address
- 40 S River Rd
Unit 58
Bedford, NH 03110-6719 - Phone
- (603) 626-4205
- Fax
- (603) 668-9943
- NPI assigned
- Oct 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2299 | NH | Primary |
Addresses
Primary practice location
40 S River Rd
Unit 58
Bedford, NH 03110-6719
Mailing address
40 S River Rd
Unit 58
Bedford, NH 03110-6719
Phone (603) 626-4205
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2299 | NH | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merrimack Valley Physical Therapy | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316936255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 S RIVER RD",
"address_2": "UNIT 58",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106719",
"telephone_number": "603-626-4205",
"fax_number": "603-668-9943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 S RIVER RD",
"address_2": "UNIT 58",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106719",
"telephone_number": "603-626-4205",
"fax_number": "603-668-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVENZIO",
"first_name": "HEATHER",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NH",
"license": "2299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.