Individual provider Active NPI

Marie Elena Hettinger, PT, DPT, LAT, ATC

  • Physical Therapist
  • Shelbyville, KY
National Provider Identifier
1992881817
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
727 Hospital Dr
Shelbyville, KY 40065-1660
Phone
(502) 647-4285
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36001107A IN
Physical Therapist 225100000X Primary

Addresses

Primary practice location

727 Hospital Dr
Shelbyville, KY 40065-1660

Mailing address

727 Hospital Dr
Shelbyville, KY 40065-1660
Phone (502) 647-4285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006002220 KY Practitioner - Physical Therapist in Private Practice 8426477795 Reassigns benefits to 2 organizations

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
Body Structure Clinic IncGroup PAC ID 8921903469, 2 clinicians
Warren Physical Therapy PLLCGroup PAC ID 0042705089, 4 clinicians

Practice addresses (Care Compare)

2600 Gribbin Dr
Lexington, KY 40517-4498
Phone (859) 268-8190

880 Corporate Dr
Suite 202
Lexington, KY 40503-5449
Phone (859) 219-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36001107AINMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Body Structure Clinic Inc. Physical Therapist CurrentSince Jul 3, 2020 Accepting new patients
Warren Physical Therapy PLLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients
Bauman Physical Therapy PSC Physical Therapist PastSince May 1, 2013 Accepting new patients

Locations

615 Delzan Pl
Lexington, KY 40503
Phone (859) 219-2233

2600 Gribbin Dr
Lexington, KY 40517
Phone (859) 268-8190

880 Corporate Dr
Ste 202
Lexington, KY 40503
Phone (859) 460-7778

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1992881817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTINGER",
        "first_name": "MARIE",
        "middle_name": "ELENA",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001107A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.