Active NPI
Heather Michelle Colvin, DPT
- Physical Therapist
- Poplar Bluff, MO
National Provider Identifier
1477895795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2013004037
- Practice address
- 2139 County Road 608
Poplar Bluff, MO 63901-5267 - Phone
- (573) 300-7961
- NPI assigned
- Mar 25, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2013004037 | MO | Primary |
Addresses
Primary practice location
2139 County Road 608
Poplar Bluff, MO 63901-5267
Mailing address
2139 County Road 608
Poplar Bluff, MO 63901-5267
Phone (573) 300-7961
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2013004037 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364169600000",
"number": "1477895795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2139 COUNTY ROAD 608",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639015267",
"telephone_number": "573-300-7961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2139 COUNTY ROAD 608",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639015267",
"telephone_number": "573-300-7961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLVIN",
"first_name": "HEATHER",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-25",
"last_updated": "2013-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2013004037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.