Individual provider Active NPI

Christopher Heezen, PT, DPT

  • Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1639681216
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2074 Issued in SD
Practice address
815 S Minnesota Ave
Sioux Falls, SD 57104-4828
Phone
(605) 231-5586
Fax
(605) 231-5587
NPI assigned
Nov 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13442 AZ
Physical Therapist 225100000X 2074 SD Primary

Addresses

Primary practice location

815 S Minnesota Ave
Sioux Falls, SD 57104-4828

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171229002432 AZ Practitioner - Physical Therapist in Private Practice 1153689823
I20200530000268 SD Practitioner - Physical Therapist in Private Practice 1153689823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

815 S Minnesota Ave
Sioux Falls, SD 57104-4828
Phone (605) 231-5586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13442AZMDPhysical Therapist
2074SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys Current Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 31, 2021 Accepting new patients
Avera St Marys CurrentSince Mar 1, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 31, 2021 Accepting new patients
Avera St Marys CurrentSince Mar 1, 2020 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

815 S Minnesota Ave
Sioux Falls, SD 57104
Phone (605) 231-5586

Organizations & group practices 5

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": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1639681216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044828",
            "telephone_number": "605-231-5586",
            "fax_number": "605-231-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEZEN",
        "first_name": "CHRISTOPHER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-03",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13442",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.