NPIMap

Organization Active NPI

Authentic Hand Therapy LLC

  • Physical Rehabilitation Occupational Therapist
  • Medford, OR
National Provider Identifier
1831734128
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
Legal business name
AUTHENTIC HAND THERAPY LLC
Practice address
724 S Central Ave Ste 107
Medford, OR 97501-7808
Phone
(248) 219-7053
NPI assigned
Nov 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Heidi J Wills, OTR/L CHTNPI 1316492440
Title
Owner
Phone
(248) 219-7053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0019X Primary

Addresses

Primary practice location

724 S Central Ave Ste 107
Medford, OR 97501-7808

Mailing address

724 S Central Ave Ste 107
Medford, OR 97501-7808
Phone (248) 219-7053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200210000546 OR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1951737030 Receives reassigned benefits from 5 practitioners
Practice locations: Medford, OR
O20200819002765 OR DME Supplier - Independently-Practicing Occupational Therapist 1951737030 Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

724 S Central Ave
Ste 107
Medford, OR 97501
Phone (248) 219-7053

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1831734128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S CENTRAL AVE STE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017808",
            "telephone_number": "248-219-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S CENTRAL AVE STE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017808",
            "telephone_number": "248-219-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC HAND THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "WILLS",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-219-7053",
        "authorized_official_credential": "OTR/L CHT"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.