Individual provider Active NPI

Heather Leigh Culpepper, P.T.

  • Physical Therapist
  • Wailuku, HI
National Provider Identifier
1346307410
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2017 Issued in HI
Practice address
80 Mahalani St
Wailuku, HI 96793-2531
Phone
(808) 243-6000
NPI assigned
Jan 2, 2007
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2017 HI Primary

Addresses

Primary practice location

80 Mahalani St
Wailuku, HI 96793-2531

Mailing address

571 Mikioi PL
Kihei, HI 96753-9458
Phone (808) 250-5761

Other practice location 1

571 Mikioi Pl
Kihei, HI 96753-9458
Phone (808) 250-5761

Other identifiers 2

IdentifierTypeStateIssuer
203328187OtherHITRICARE
00C0235469OtherHIBLUE CROSS BLUE SHEILD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
PT2017HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraputic Fusion: Physical Therapy & Wellness, LLC Physical Therapist 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, 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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1346307410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 MIKIOI PL",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967539458",
            "telephone_number": "808-250-5761",
            "fax_number": "808-891-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932531",
            "telephone_number": "808-243-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 Mikioi Pl",
            "address_purpose": "LOCATION",
            "city": "Kihei",
            "state": "HI",
            "postal_code": "967539458",
            "country_code": "US",
            "telephone_number": "808-250-5761",
            "fax_number": "808-891-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULPEPPER",
        "first_name": "HEATHER",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT2017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "203328187",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "00C0235469",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "80 Mahalani St",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967932531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.