Heather C Vaughan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305207012 Issued in VA

Practice address

14302 Winterview Pkwy
Midlothian, VA 23113-4386

Phone

(804) 601-6010

Fax

(804) 802-5603

NPI assigned

Aug 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Heather Marie Conroy Former name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433
  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment NPD
• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  VA

  Medicare reassignment NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Physical Therapist

  NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1477588986
  NPD
• Tidewater Physical Therapy LLC

  • Physical Therapist
  • Norfolk, VA
  • NPI 1205345444
  NPD (past)
• Tidewater Physical Therapy LLC

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1427561984
  NPD (past)
• Tidewater Physical Therapy LLC

  • Physical Therapist
  • Salem, VA
  • NPI 1841700432
  NPD (past)
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1083133268
  NPD (past)
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Charlottesville, VA
  • NPI 1932648649
  NPD (past)

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1619255916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14302 WINTERVIEW PKWY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134386",
            "telephone_number": "804-601-6010",
            "fax_number": "804-802-5603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3510 Anderson Hwy Ste 2",
            "address_purpose": "LOCATION",
            "city": "Powhatan",
            "state": "VA",
            "postal_code": "231395846",
            "country_code": "US",
            "telephone_number": "804-598-2100",
            "fax_number": "804-598-7624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "HEATHER",
        "middle_name": "C",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB",
            "identifier": "1616255916",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "C05954",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CONROY",
            "middle_name": "MARIE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Neil Vanpelt, ED.D.
• Carolyn F. Vargas-Jackson, CCC/SLP
• Morgan L. Vargo, MD
• Taylor Varner, DDS
• Helena Varys, MD
• Rachel Vaughan, BCBA, LBA
• Sparkle Electra Vaughan
• Jodi A Vaughn, O.D.
• Lymari Velez
• Patrick Gilbert Veltman Jr., RPH

• Physical Therapist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.