Individual provider Active NPI

Keith Heischober, DPT

  • Orthopedic Physical Therapist
  • Roanoke, VA
National Provider Identifier
1629307624
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305206289 Issued in VA
Practice address
4533 Brambleton Ave
Roanoke, VA 24018-3436
Phone
(540) 772-8022
Fax
(540) 527-0057
NPI assigned
Dec 22, 2009
Last updated
Sep 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2305206289 VA Primary

Addresses

Primary practice location

4533 Brambleton Ave
Roanoke, VA 24018-3436

Mailing address

4533 Brambleton Ave
Roanoke, VA 24018-3436
Phone (540) 772-8022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7768 Williamson Rd
Roanoke, VA 24019-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305206289VAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Health Corporation CurrentSince Mar 24, 2017 Accepting new patients
Tracy M. Hernandez, Inc. Orthopedic PastSince Dec 22, 2001 Accepting new patients
Atlantic Physical Therapy PC Orthopedic PastSince Oct 17, 2010 Accepting new patients

Locations

7768 Williamson Rd
Roanoke, VA 24019
Phone (540) 985-0500

Interoperability endpoints

  • Direct secure messaging: keith.heischober.1@16094.direct.athenahealth.com

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": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1629307624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183436",
            "telephone_number": "540-772-8022",
            "fax_number": "540-527-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183436",
            "telephone_number": "540-772-8022",
            "fax_number": "540-527-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISCHOBER",
        "first_name": "KEITH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305206289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.