Individual provider Active NPI

Ann Marie Heuertz, COTA

  • Occupational Therapy Assistant
  • San Angelo, TX
National Provider Identifier
1548742018
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
207165 Issued in WI
Practice address
3745 Summer Crest Dr
San Angelo, TX 76901-9782
Phone
(325) 942-7700
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 207165 WI Primary

Addresses

Primary practice location

3745 Summer Crest Dr
San Angelo, TX 76901-9782

Mailing address

2714 Red Bluff Ramp Rd
San Angelo, TX 76904-7844
Phone (325) 212-1404

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
207165WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1548742018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 RED BLUFF RAMP RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047844",
            "telephone_number": "325-212-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 SUMMER CREST DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769019782",
            "telephone_number": "325-942-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEUERTZ",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "207165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.