Individual provider Active NPI

Heather Wonderlich, P.T.

  • Physical Therapist
  • Bellevue, NE
National Provider Identifier
1942442389
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2729 Issued in NE
Practice address
1804 Hillcrest Dr
Bellevue, NE 68005-3663
Phone
(402) 650-8954
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 2729 NE Primary

Addresses

Primary practice location

1804 Hillcrest Dr
Bellevue, NE 68005-3663

Mailing address

13616 California St
Ste 100
Omaha, NE 68154-5336
Phone (402) 496-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000038 NE Practitioner - Physical Therapist in Private Practice 5193980530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Spine Center, LLPGroup PAC ID 9830080613, 35 clinicians

Practice addresses (Care Compare)

13616 California St
Suite 100
Omaha, NE 68154-5336
Phone (402) 496-5517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2729NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Spine Center, LLP Physical Therapist CurrentSince May 21, 2012 Accepting new patients

Locations

13616 California St
Ste 100
Omaha, NE 68154
Phone (402) 496-5517

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71581

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1942442389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST",
            "address_2": "STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-0404",
            "fax_number": "402-496-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 HILLCREST DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053663",
            "telephone_number": "402-650-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONDERLICH",
        "first_name": "HEATHER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.