Heather Bittle, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A7653 Issued in NC

Practice address

1200 Old Fairground Rd
Willow Spring, NC 27592-9689

Phone

(919) 623-2714

NPI assigned

Sep 21, 2021

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2021.

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1760153704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OLD FAIRGROUND RD",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275929689",
            "telephone_number": "919-623-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD FAIRGROUND RD",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275929689",
            "telephone_number": "919-623-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITTLE",
        "first_name": "HEATHER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A7653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Safe Haven Wellness & Primary Care, LLC
• A Safe Haven Wellness & Primary Care, LLC
• Carmen Alexia Ackermann
• Abigail Baker, AGACNP
• Samantha Jean Beverage
• Elizabeth K Broughton, MOT, OTR/L
• Alan L Byrd, OD
• Candice Castleberry
• Avery Chase
• Alison Bethany Chavarriaga, MS, CCC-SLP

• All providers in Willow Spring, NC
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.