Individual provider Active NPI

Tori Heckendorn

  • Physical Therapist
  • Eagle River, AK
National Provider Identifier
1609415926
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
295559 Issued in CA
Practice address
17101 Snowmobile LN Ste 202
Eagle River, AK 99577-7043
Phone
(907) 694-8085
NPI assigned
Jan 3, 2020
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 295559 CA Primary

Addresses

Primary practice location

17101 Snowmobile LN Ste 202
Eagle River, AK 99577-7043

Mailing address

17101 Snowmobile LN Ste 202
Eagle River, AK 99577-7043

Other practice location 1

655 S Willow St Ste 128
Manchester, NH 03103-5717
Phone (800) 995-2673

Other practice location 2

124 S College Dr
Santa Maria, CA 93454-5325
Phone (877) 428-8527

Other practice location 3

400 Indiana St Ste 340
Golden, CO 80401-5033
Phone (720) 452-1267

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

LicenseStateTypeSpecialty
295559CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Oct 31, 2022 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Oct 31, 2022 Accepting new patients

Locations

17101 Snowmobile Ln
Ste 202
Eagle River, AK 99577
Phone (907) 357-9755

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1609415926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN STE 202",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN STE 202",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777043",
            "telephone_number": "907-694-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 S Willow St Ste 128",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031035717",
            "country_code": "US",
            "telephone_number": "800-995-2673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 S College Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545325",
            "country_code": "US",
            "telephone_number": "877-428-8527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Indiana St Ste 340",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804015033",
            "country_code": "US",
            "telephone_number": "720-452-1267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HECKENDORN",
        "first_name": "TORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.