Individual provider Active NPI

Heather Michelle Carlyle, P.T.

  • Physical Therapist
  • Buford, GA
National Provider Identifier
1740489327
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009097 Issued in GA
Practice address
4965 Lanier Islands Pkwy Ste 103
Buford, GA 30518-1717
Phone
(470) 214-9076
NPI assigned
Jul 13, 2007
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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 PT009097 GA Primary

Addresses

Primary practice location

4965 Lanier Islands Pkwy Ste 103
Buford, GA 30518-1717

Mailing address

4965 Lanier Islands Pkwy Ste 103
Buford, GA 30518-1717
Phone (470) 214-9076

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heather@healingessentialspt.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924000054 GA Practitioner - Physical Therapist in Private Practice 1254738842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

2900 McEver Rd
Gainesville, GA 30504-5516
Phone (978) 940-1101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT009097GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Stop Physical Therapy, Wellness and Home Safety LLC Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Dec 8, 2023 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Dec 8, 2023 Accepting new patients

Locations

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

2900 McEver Rd
Gainesville, GA 30504
Phone (678) 940-1101

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, 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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1740489327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 LANIER ISLANDS PKWY STE 103",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181717",
            "telephone_number": "470-214-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 LANIER ISLANDS PKWY STE 103",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181717",
            "telephone_number": "470-214-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "HEATHER",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heather@healingessentialspt.com",
            "affiliation": "N",
            "endpointDescription": "clinic email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4965 Lanier Islands Pkwy Ste 103",
            "city": "Buford",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305181717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.