Individual provider Active NPI

Heather Jane Durrett, M.P.T.

  • Physical Therapist
  • Bradenton, FL
National Provider Identifier
1427080696
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18718 Issued in FL
Practice address
13638 2ND Ave NE
Bradenton, FL 34212-2725
Phone
(941) 228-6734
Fax
(941) 343-9402
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 PT18718 FL Primary

Addresses

Primary practice location

13638 2ND Ave NE
Bradenton, FL 34212-2725

Mailing address

11441 Dancing River Dr
Venice, FL 34292-4127
Phone (941) 493-6979

Other identifiers 1

IdentifierTypeStateIssuer
Y8758OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Miss Heather Jane Knudsen Former name

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
PT18718FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back on Track Physical Therapy, LLC Physical Therapist CurrentSince Sep 15, 2010 Accepting new patients
Florida Physical Therapy Services of Sarasota LLC Physical Therapist CurrentSince Oct 14, 2023 Accepting new patients
On the Go Therapy Services Inc Physical Therapist PastSince Jan 18, 2005 Accepting new patients

Locations

3251 Proctor Rd
Sarasota, FL 34231
Phone (941) 256-3259

Organizations & group practices 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1427080696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 DANCING RIVER DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342924127",
            "telephone_number": "941-493-6979",
            "fax_number": "941-484-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13638 2ND AVE NE",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342122725",
            "telephone_number": "941-228-6734",
            "fax_number": "941-343-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRETT",
        "first_name": "HEATHER",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y8758",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "KNUDSEN",
            "middle_name": "JANE",
            "prefix": "MISS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.