Heatherlynn Wincapaw Gruber, PTA

Individual provider Active NPI Physical Therapy Assistant · Elgin, OK

NPI 1942908579 · NPPES record last updated Feb 22, 2023

Key facts

NPI
1942908579
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2693 (OK)
Practice address
8355 US Highway 277
Elgin, OK 73538-2207
Phone
(580) 492-1112
NPI assigned
Feb 22, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Health Oklahoma Outpatient Clinics LLC Past
since May 16, 2021
Accepting new patients
Valir Hospice Care, LLC Past
since Jan 25, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2693 OK Yes

Addresses

Primary practice location

8355 US Highway 277
Elgin, OK 73538-2207

Mailing address

105 NE Sunset Dr
Elgin, OK 73538-2347
Phone (719) 306-5854

Other practice location 1

800 NW 6th St
Oklahoma City, OK 73106-7241
Phone (405) 609-3667

Other providers in Elgin, OK

All providers in Elgin, OK · Physical Therapy Assistant in Oklahoma

Sources for this page

Verify at the official NPI Registry.