Individual provider Active NPI

Heather Nicole Derenick, DPT

  • Physical Therapist
  • Spring Grove, PA
National Provider Identifier
1700367000
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT027106 Issued in PA
Practice address
488 N Main St
Spring Grove, PA 17362-1122
Phone
(717) 690-0107
Fax
(717) 974-8743
NPI assigned
Aug 24, 2018
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT027106 PA Primary

Addresses

Primary practice location

488 N Main St
Spring Grove, PA 17362-1122

Mailing address

4750 Lindle Rd Ste 100
Harrisburg, PA 17111-2428
Phone (717) 803-3342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921001157 PA Practitioner - Physical Therapist in Private Practice 8224389788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 Palomino Rd
Unit 200
Dover, PA 17315-3648
Phone (717) 534-3584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT027106PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHM Physical Therapy Institute LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince May 3, 2021 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince May 3, 2021 Accepting new patients
Oss Orthopaedic Hospital, LLC Current Accepting new patients
Oss Orthopaedic Hospital, LLC CurrentSince Aug 14, 2018 Accepting new patients
LHM Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Oss Orthopaedic Hospital, LLC CurrentSince Aug 14, 2018 Accepting new patients
LHM Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
LHM Physical Therapy Institute LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

120 N Baltimore St
#110
Dillsburg, PA 17019
Phone (717) 501-3100

2251 Palomino Rd
Unit 200
Dover, PA 17315
Phone (717) 534-3584

470 Eisenhower Dr
Hanover, PA 17331
Phone (717) 633-0031

4750 Lindle Rd
Ste 100
Harrisburg, PA 17111
Phone (717) 803-3342

558 Shrewsbury Commons Ave
Shrewsbury, PA 17361
Phone (717) 803-3344

1805 Loucks Rd
Ste 200
York, PA 17408
Phone (717) 764-0144

1855 Powder Mill Rd
York, PA 17402

1861 Powder Mill Rd
Ofc
York, PA 17402
Phone (717) 718-2000

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1700367000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 LINDLE RD STE 100",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112428",
            "telephone_number": "717-803-3342",
            "fax_number": "717-974-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 N MAIN ST",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "173621122",
            "telephone_number": "717-690-0107",
            "fax_number": "717-974-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERENICK",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT027106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.