Stacey M Heffernan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15982 Issued in MA

Practice address

100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6115

Phone

(978) 927-0907

Fax

(978) 927-0537

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey M Pedersen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Burlington Physical Therapy, PC Dba Orthopaedics Plus

  • Physical Therapist
  • Beverly, MA
  • NPI 1912204850
  NPD (past)
• Burlington Physical Therapy, PC, Dba Orthopaedics Plus

  • Physical Therapist
  • Bedford, MA
  • NPI 1932130465
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699840348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033766",
            "telephone_number": "781-229-8011",
            "fax_number": "781-229-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 121Q",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-927-0907",
            "fax_number": "978-927-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "PEDERSEN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Healthquarters, Inc
• Healthquarters, Inc
• Hearing Healthcare Associates
• Craig Hearns
• Sydney V Hearns
• Heidi Busch
• Nathaniel Robert Heim, DPT
• Paula Heimberg, MD
• Lewis Heinlein
• Agnieszka Maria Heith, MD

• Physical Therapist in Beverly, MA
• Providers in Beverly, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.