NPIMap

Individual provider Active NPI

Heksa Purwitasari, MT

  • Specialist
  • Highlands Ranch, CO
National Provider Identifier
1356623367
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5143 Issued in CO
Practice address
9299 S Broadway # 100
Highlands Ranch, CO 80129-5603
Phone
(303) 683-3377
Fax
(303) 683-1453
NPI assigned
Sep 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5143 CO Primary

Addresses

Primary practice location

9299 S Broadway # 100
Highlands Ranch, CO 80129-5603

Mailing address

9299 S Broadway # 100
Highlands Ranch, CO 80129-5603
Phone (303) 683-3377

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
5143COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Care LLC Current Accepting new patients
Primary Care and Chiropractic Inc Past Accepting new patients

Organizations & group practices 2

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": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1356623367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9299 S BROADWAY # 100",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801295603",
            "telephone_number": "303-683-3377",
            "fax_number": "303-683-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9299 S BROADWAY # 100",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801295603",
            "telephone_number": "303-683-3377",
            "fax_number": "303-683-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURWITASARI",
        "first_name": "HEKSA",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "5143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.