Active NPI
Heidi Jo Young Hetland, PT, DPT, MS, PCS
- Pediatric Physical Therapist
- Durham, NC
National Provider Identifier
1467584698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 5172
- Practice address
- 1214 Goldenview CT
Durham, NC 27713-8207 - Phone
- (919) 698-2970
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 5172 | NC | Primary |
Addresses
Primary practice location
1214 Goldenview CT
Durham, NC 27713-8207
Mailing address
1214 Goldenview CT
Durham, NC 27713-8207
Phone (919) 484-8144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89776 | Other | NC | BCBS OF NC |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5172 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1467584698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 GOLDENVIEW CT",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138207",
"telephone_number": "919-484-8144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 GOLDENVIEW CT",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138207",
"telephone_number": "919-698-2970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETLAND",
"first_name": "HEIDI JO",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "PT, DPT, MS, PCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "5172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "89776",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.