Heather Conway, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

004905-01 Issued in NY

Practice address

101 Adirondack Dr Ste 1
Ticonderoga, NY 12883-9334

Phone

(518) 585-3810

Fax

(518) 585-3822

NPI assigned

Oct 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1831592880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ADIRONDACK DR STE 1",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "128839334",
            "telephone_number": "518-585-3810",
            "fax_number": "518-585-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ADIRONDACK DR STE 1",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "128839334",
            "telephone_number": "518-585-3810",
            "fax_number": "518-585-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "HEATHER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004905-1",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004905-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J Berrick, RPA-C
• Wendy Lynn Bresett, PT
• Nancy Alexandra Caffrey, PA-C
• Chaddher Imports Inc
• Glen D Chapman, MD
• Dean Lewis Cook, DMD
• Philip L Crank Jr., RPH
• Pragya Datt, PT
• Thomas Jay Decker I
• Vanessa Defayette, RN

• Physical Therapy Assistant in Ticonderoga, NY
• Providers in Ticonderoga, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.