Individual provider Active NPI

Cory Scott Heinkel, PT

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1639201239
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7091 Issued in TN
Practice address
1789 Kirby Pkwy
Suite 3
Memphis, TN 38138-3608
Phone
(901) 759-1282
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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 7091 TN Primary

Addresses

Primary practice location

1789 Kirby Pkwy
Suite 3
Memphis, TN 38138-3608

Mailing address

1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone (901) 767-8690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702003084 TN Practitioner - Physical Therapist in Private Practice 3375899438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7091TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Physical Therapist CurrentSince May 1, 2018 Accepting new patients
MSK Group, PC Physical Therapist CurrentSince May 1, 2018 Accepting new patients
Rehab, Etc., Inc. Physical Therapist PastSince Sep 5, 2021 Accepting new patients
MSK Group PC Physical Therapist Past Accepting new patients

Locations

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

1350 Concourse Ave
Ste 363
Memphis, TN 38104
Phone (901) 260-6155

1244 Primacy Pkwy
Memphis, TN 38119
Phone (901) 767-8662

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 4

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1639201239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 KIRBY PKWY",
            "address_2": "SUITE 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383608",
            "telephone_number": "901-759-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINKEL",
        "first_name": "CORY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "7091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.