NPIMap

Individual provider Active NPI

Heather A Jackson

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1861820755
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0002027 Issued in DE
Practice address
501 W 14TH St
Wilmington Hospital, Physical Therapy Dept
Wilmington, DE 19801-1013
Phone
(302) 428-6677
NPI assigned
Oct 31, 2013
Last updated
Oct 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017881 PA
Physical Therapist 225100000X J1-0002027 DE Primary

Addresses

Primary practice location

501 W 14TH St
Wilmington Hospital, Physical Therapy Dept
Wilmington, DE 19801-1013

Mailing address

200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049

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

LicenseStateTypeSpecialty
J1-0002027DEMDPhysical Therapist
PT017881PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1861820755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST",
            "address_2": "WILMINGTON HOSPITAL, PHYSICAL THERAPY DEPT",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-428-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEATHER",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017881",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.