Individual provider Active NPI

James Heeren, PT

  • Physical Therapist
  • Enfield, CT
National Provider Identifier
1508265174
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010235 Issued in CT
Practice address
7 Elm St
Suite 204
Enfield, CT 06082-3669
Phone
(860) 741-2242
Fax
(860) 741-2248
NPI assigned
Aug 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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 010235 CT Primary

Addresses

Primary practice location

7 Elm St
Suite 204
Enfield, CT 06082-3669

Mailing address

7 Elm St
Suite 204
Enfield, CT 06082-3669
Phone (860) 741-2242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160808001798 CT Practitioner - Physical Therapist in Private Practice 5597059972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Connecticut School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Specialists of Guilford, LLCGroup PAC ID 8820263759, 13 clinicians

Practice addresses (Care Compare)

705 Boston Post Rd
Suite 5a
Guilford, CT 06437-2733
Phone (203) 458-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010235CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists Physical Therapist CurrentSince May 31, 2016 Accepting new patients
Physical Therapy Specialists PastSince May 31, 2016 Accepting new patients

Locations

705 Boston Post Rd
Ste 5A
Guilford, CT 06437
Phone (203) 458-1645

840 Boston Post Rd
#200
Old Saybrook, CT 06475
Phone (203) 458-1645

Organizations & group practices 2

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1508265174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ELM ST",
            "address_2": "SUITE 204",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823669",
            "telephone_number": "860-741-2242",
            "fax_number": "860-741-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ELM ST",
            "address_2": "SUITE 204",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823669",
            "telephone_number": "860-741-2242",
            "fax_number": "860-741-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEREN",
        "first_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.