Individual provider Active NPI

Hailey K. Himes

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1972720357
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 33556 Issued in CA
Practice address
609 E Orangeburg Ave
101
Modesto, CA 95350-5512
Phone
(209) 572-3224
Fax
(209) 572-4528
NPI assigned
Apr 19, 2007
Last updated
Jun 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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 PT 33556 CA Primary

Addresses

Primary practice location

609 E Orangeburg Ave
101
Modesto, CA 95350-5512

Mailing address

609 E Orangeburg Ave
101
Modesto, CA 95350-5512
Phone (209) 572-3224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000259 CA Practitioner - Physical Therapist in Private Practice 4284720186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanislaus Orthopaedic and Sports Medicine ClinicGroup PAC ID 0042373862, 9 clinicians

Practice addresses (Care Compare)

609 E Orangeburg Ave
Suite 201
Modesto, CA 95350-5512
Phone (209) 572-3224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 33556CAMDPhysical Therapist
33556CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Health & Wellness LLC Past Accepting new patients
Pain Management Services and Physical Therapy Inc. Physical Therapist PastSince Oct 6, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1972720357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "address_2": "101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505512",
            "telephone_number": "209-572-3224",
            "fax_number": "209-572-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "address_2": "101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505512",
            "telephone_number": "209-572-3224",
            "fax_number": "209-572-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMES",
        "first_name": "HAILEY",
        "middle_name": "K.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 33556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.