Individual provider Active NPI

Kourtney Heitz, PT

  • Physical Therapist
  • Arnold, MO
National Provider Identifier
1710210604
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2009034737 Issued in MO
Practice address
118 Richardson Xing
Arnold, MO 63010-6023
Phone
(636) 206-4146
NPI assigned
Sep 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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 2009034737 MO Primary

Addresses

Primary practice location

118 Richardson Xing
Arnold, MO 63010-6023

Mailing address

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-4225

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009034737MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1710210604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 KEATON CROSSING BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688220",
            "telephone_number": "636-206-4225",
            "fax_number": "636-422-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 RICHARDSON XING",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106023",
            "telephone_number": "636-206-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZ",
        "first_name": "KOURTNEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2009034737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.