Austin Heschong-Nippert, DPT

Individual provider Active NPI Physical Therapist · Roseville, CA

NPI 1689259590 · NPPES record last updated Mar 11, 2021

Key facts

NPI
1689259590
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
299949 (CA)
Practice address
1836 Hiawatha Dr
Roseville, CA 95747-4808
Phone
(916) 474-0369
NPI assigned
Mar 11, 2021
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Sports Physical Therapy Centers Inc (37 clinicians)

Practice addresses (Care Compare)

2217 Sunset Blvd
Suite 711
Rocklin, CA 95765-4783
Phone (916) 435-3500

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210428002899 CA Practitioner - Physical Therapist in Private Practice 9638588833 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
299949CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Sports Physical Therapy Centers, Inc. Physical Therapist Current Accepting new patients
California Sports Physical Therapy Centers, Inc. Physical Therapist Current
since Nov 14, 2022
Accepting new patients
California Sports Physical Therapy Centers Inc Physical Therapist Current
since Nov 14, 2022
Accepting new patients

Locations

2217 Sunset Blvd
Ste 711
Rocklin, CA 95765
Phone (916) 435-3500

5910 Pacific Ave
#I
Stockton, CA 95207
Phone (209) 475-1000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299949 CA Yes

Addresses

Primary practice location

1836 Hiawatha Dr
Roseville, CA 95747-4808

Mailing address

1836 Hiawatha Dr
Roseville, CA 95747-4808
Phone (916) 474-0369

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 11, 2021.

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1689259590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 HIAWATHA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474808",
            "telephone_number": "916-474-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 HIAWATHA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474808",
            "telephone_number": "916-474-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESCHONG-NIPPERT",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

All providers in Roseville, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.