Active NPI
Gary D Higginbotham, PT
- Orthopedic Physical Therapist
- Carmel, IN
National Provider Identifier
1922044452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 05001901A
- Practice address
- 1185 W Carmel Dr BLDG C
Carmel, IN 46032-8708 - Phone
- (317) 582-8924
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 05001901A | IN | Primary |
Addresses
Primary practice location
1185 W Carmel Dr BLDG C
Carmel, IN 46032-8708
Mailing address
1185 W Carmel Dr BLDG C
Carmel, IN 46032-8708
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200362000B | Medicaid | IN | |
| 5640539 | Other | IN | AETNA |
| 000000222168 | Other | IN | ANTHEM GROUP# |
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 |
|---|---|---|---|
| 05001901A | IN | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body One Health and Fitness Center, LLC | Orthopedic | Past | Accepting new patients |
| Physical Therapy, Inc | Past | Accepting new patients | |
| Request Physical Therapy, Inc. | Orthopedic | Past | Accepting new patients |
| HTS Outpatient Therapy Services, LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Physical Therapist
- Indianapolis, IN
- NPI 1528092442
Orthopedic
-
- Physical Therapy Clinic/Center
- Indianapolis, IN
- NPI 1801891890
-
- Physical Therapy Clinic/Center
- Avon, IN
- NPI 1578597654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1922044452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1185 W CARMEL DR BLDG C",
"city": "CARMEL",
"state": "IN",
"postal_code": "460328708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1185 W CARMEL DR BLDG C",
"city": "CARMEL",
"state": "IN",
"postal_code": "460328708",
"telephone_number": "317-582-8924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGINBOTHAM",
"first_name": "GARY",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IN",
"license": "05001901A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200362000B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5640539",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM GROUP#",
"identifier": "000000222168",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.