Healing Foundations Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1149167 Issued in TX

Legal business name

HEALING FOUNDATIONS PHYSICAL THERAPY, LLC

Practice address

6810 Poncha Pass
Austin, TX 78749-4370

Phone

(512) 814-6526

Fax

(512) 265-2148

NPI assigned

Jun 4, 2014

Organization subpart

No

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

Authorized official

Name

Carrie Ann Ciaverelli, PTNPI 1538292719

Title

Owner

Phone

(512) 814-6526

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Carrie Ciaverelli, PT

  • Physical Therapist
  • Austin, TX
  • NPI 1538292719
  NPD Authorized official

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1861805103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 PONCHA PASS",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78749",
            "telephone_number": "512-814-6526",
            "fax_number": "512-265-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 PONCHA PASS",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494370",
            "telephone_number": "512-814-6526",
            "fax_number": "512-265-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING FOUNDATIONS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "CIAVERELLI",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-814-6526",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1149167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #: 8T6544",
            "identifier": "1538292719",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER 282472YRH",
            "identifier": "1538292719",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.