Individual provider Active NPI

Marjorie A Herweyer, RPT

  • Pediatric Physical Therapist
  • Conifer, CO
National Provider Identifier
1497066591
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1240 Issued in CO
Practice address
27551 Shadow Mountain Dr
Conifer, CO 80433-8607
Phone
(303) 838-7197
Fax
(303) 838-7197
NPI assigned
Jun 24, 2010
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 1240 CO
Pediatric Physical Therapist 2251P0200X 1240 CO Primary

Addresses

Primary practice location

27551 Shadow Mountain Dr
Conifer, CO 80433-8607

Mailing address

27551 Shadow Mountain Dr
PO Box 843
Conifer, CO 80433-8607
Phone (303) 838-7197

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
1240COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1497066591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27551 SHADOW MOUNTAIN DR",
            "address_2": "PO BOX 843",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804338607",
            "telephone_number": "303-838-7197",
            "fax_number": "303-838-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27551 SHADOW MOUNTAIN DR",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804338607",
            "telephone_number": "303-838-7197",
            "fax_number": "303-838-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERWEYER",
        "first_name": "MARJORIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "1240",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CO",
            "license": "1240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conifer, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.