Melinda C Heimerl, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2093-19 Issued in WI

Practice address

2763 Manitowoc Rd
Ste B
Green Bay, WI 54311-6633

Phone

(920) 468-8288

Fax

(920) 468-9887

NPI assigned

Mar 11, 2014

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 identifiers 1

Other names 1

• Melinda C Wilber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Bellevue Total Health, SC

  • Occupational Health Nurse Practitioner
  • Green Bay, WI
  • NPI 1447203013
  NPD (past)

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1801212089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 MANITOWOC RD",
            "address_2": "STE B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116633",
            "telephone_number": "920-468-8288",
            "fax_number": "920-468-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2763 MANITOWOC RD",
            "address_2": "STE B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116633",
            "telephone_number": "920-468-8288",
            "fax_number": "920-468-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMERL",
        "first_name": "MELINDA",
        "middle_name": "C",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2093-19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2093-19",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "WILBER",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabrielle Heier, SLP
• Austin Kendrew Heim, PA-C
• Julie Ann Heim
• Tracy G Heim, PT
• Cameron Jade Heiman
• Anne Marie Hein, PT
• Joel Evan Hein, M.D.
• Steven R Hein, D.D.S.
• Rachele Heinrich, MA CCC-SLP
• Amber Leigh Heinz, MS/CCC-SLP

• Physical Therapy Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.