Heather Lynn Ackley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40757 Issued in CA

Practice address

18271 McDurmott W
J
Irvine, CA 92614-6754

Phone

(949) 752-2227

Fax

(949) 752-2231

NPI assigned

Dec 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Womanology

  • Physical Therapist
  • Irvine, CA
  • NPI 1811902208
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1689005191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18271 MCDURMOTT W",
            "address_2": "J",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146754",
            "telephone_number": "949-752-2227",
            "fax_number": "949-752-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18271 MCDURMOTT W",
            "address_2": "J",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146754",
            "telephone_number": "949-752-2227",
            "fax_number": "949-752-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKLEY",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT40757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT40757",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Irvine, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.