Individual provider Active NPI

Heather Katherine Huckert, D.P.T.

  • Physical Therapist
  • Grants Pass, OR
National Provider Identifier
1962611046
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6722 Issued in OR
Practice address
942 SW 6TH St. Suite G
Grants Pass, OR 97526
Phone
(541) 472-1799
Fax
(541) 472-1699
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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 1563 AK
Physical Therapist 225100000X 6722 OR Primary

Addresses

Primary practice location

942 SW 6TH St. Suite G
Grants Pass, OR 97526

Mailing address

1410 Redfin LN
Grants Pass, OR 97527
Phone (541) 613-0353

Other identifiers 2

IdentifierTypeStateIssuer
6722OtherORSTATE OF OREGON PHYSICAL THERAPIST LICENSING BOARD
PT1563MedicaidAK

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
6722ORMDPharmacist
1563AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Rehabilitation & Sports Medicine, P.C. Physical Therapist PastSince May 28, 2013 Accepting new patients

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1962611046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 REDFIN LN",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97527",
            "telephone_number": "541-613-0353",
            "fax_number": "541-613-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 SW 6TH ST. SUITE G",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-472-1799",
            "fax_number": "541-472-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKERT",
        "first_name": "HEATHER",
        "middle_name": "KATHERINE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1563",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OREGON PHYSICAL THERAPIST LICENSING BOARD",
            "identifier": "6722",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT1563",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.