Individual provider Active NPI

Austin James Heffner, MPT

  • Physical Therapist
  • Bloomington, IN
National Provider Identifier
1902060205
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05009367A Issued in IN
Practice address
2201 W Sudbury Dr Ste C
Bloomington, IN 47403-3812
Phone
(812) 333-1933
Fax
(812) 333-3991
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05009367A IN Primary

Addresses

Primary practice location

2201 W Sudbury Dr Ste C
Bloomington, IN 47403-3812

Mailing address

2201 W Sudbury Dr Ste C
Bloomington, IN 47403-3812
Phone (812) 333-1933

Other identifiers 1

IdentifierTypeStateIssuer
200929460MedicaidIN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Jan 1, 2023 Accepting new patients
Select Physical Therapy Holdings, Inc. Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

2617 16th St
Ste 12
Bedford, IN 47421
Phone (812) 578-7168

3316 E Market St
Logansport, IN 46947
Phone (574) 601-3100

Organizations & group practices 3

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1902060205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W SUDBURY DR STE C",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033812",
            "telephone_number": "812-333-1933",
            "fax_number": "812-333-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W SUDBURY DR STE C",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033812",
            "telephone_number": "812-333-1933",
            "fax_number": "812-333-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFNER",
        "first_name": "AUSTIN",
        "middle_name": "JAMES",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009367A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200929460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.