Jennifer Heisel-Mangano, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT05017 Issued in OH

Practice address

129 5TH St SE
Barberton, OH 44203-4204

Phone

(330) 631-0010

Fax

(330) 631-0011

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1982694485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 5TH ST SE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442034204",
            "telephone_number": "330-631-0010",
            "fax_number": "330-631-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 5TH ST SE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442034204",
            "telephone_number": "330-631-0010",
            "fax_number": "330-631-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEL-MANGANO",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT05017",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "OH",
            "license": "PT05017",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT05017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT PT ATC BOARD",
            "identifier": "PT05017",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Barberton, OH
• Providers in Barberton, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.