Active NPI
Heidi Jo Dejager, MSPT
- Pediatric Physical Therapist
- Parker, CO
National Provider Identifier
1861680159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 7907
- Practice address
- 16216 Sequoia Dr
Parker, CO 80134-3549 - Phone
- (720) 933-4284
- NPI assigned
- Oct 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 7907 | CO | Primary |
Addresses
Primary practice location
16216 Sequoia Dr
Parker, CO 80134-3549
Mailing address
16216 Sequoia Dr
Parker, CO 80134-3549
Phone (720) 933-4284
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09631011 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7907 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kid'S Play Physical Therapy, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1861680159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16216 SEQUOIA DR",
"city": "PARKER",
"state": "CO",
"postal_code": "801343549",
"telephone_number": "720-933-4284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16216 SEQUOIA DR",
"city": "PARKER",
"state": "CO",
"postal_code": "801343549",
"telephone_number": "720-933-4284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEJAGER",
"first_name": "HEIDI",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-11",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CO",
"license": "7907",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09631011",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.