Individual provider Active NPI

John J Heininger, PTA

  • Physical Therapy Assistant
  • Arlington, WA
National Provider Identifier
1457634347
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PT160216910 Issued in WA
Practice address
620 Hazel St
Arlington, WA 98223-8245
Phone
(425) 737-3618
Fax
(425) 642-8382
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PT160216910 WA Primary

Addresses

Primary practice location

620 Hazel St
Arlington, WA 98223-8245

Mailing address

620 Hazel St
Arlington, WA 98223-8245
Phone (425) 737-3618

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
PT160216910WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1457634347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HAZEL ST",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238245",
            "telephone_number": "425-737-3618",
            "fax_number": "425-642-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HAZEL ST",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238245",
            "telephone_number": "425-737-3618",
            "fax_number": "425-642-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEININGER",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "PT160216910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.