Individual provider Active NPI

Jamie Heggedal, LMT

  • Specialist
  • Tampa, FL
National Provider Identifier
1659558229
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA43908 Issued in FL
Practice address
14465 N Dale Mabry Hwy
Tampa, FL 33618-2000
Phone
(813) 967-8177
Fax
(813) 961-3931
NPI assigned
Jan 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA43908 FL Primary

Addresses

Primary practice location

14465 N Dale Mabry Hwy
Tampa, FL 33618-2000

Mailing address

14465 N Dale Mabry Hwy
Tampa, FL 33618-2000
Phone (813) 967-8177

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA43908FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollwood Massage Therapy Specialist Past Accepting new patients

Organizations & group practices 1

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": "1201305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1659558229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14465 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182000",
            "telephone_number": "813-967-8177",
            "fax_number": "813-961-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14465 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182000",
            "telephone_number": "813-967-8177",
            "fax_number": "813-961-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGGEDAL",
        "first_name": "JAMIE",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-26",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA43908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.