Individual provider Active NPI

Katherine Hefner, PT, DPT

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1396385720
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212310 Issued in VA
Practice address
4900 Dominion Blvd Ste B
Glen Allen, VA 23060-6773
Phone
(804) 747-4673
NPI assigned
Jan 14, 2020
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9127 SC
Physical Therapist 225100000X 2305212310 VA Primary

Addresses

Primary practice location

4900 Dominion Blvd Ste B
Glen Allen, VA 23060-6773

Mailing address

4900 Dominion Blvd Ste B
Glen Allen, VA 23060-6773

Other identifiers 2

IdentifierTypeStateIssuer
9127OtherSCSOUTH CAROLINA STATE BOARD OF PHYSICAL THERAPY
2305212310OtherVAVIRGINIA STATE BOARD OF PHYSICAL THERAPY

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

LicenseStateTypeSpecialty
2305212310VAMDPhysical Therapist
9127SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1396385720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 DOMINION BLVD STE B",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 DOMINION BLVD STE B",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606773",
            "telephone_number": "804-747-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "KATHERINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9127",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "9127",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "2305212310",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.