Healthcare Provider Details

I. General information

NPI: 1295499226
Provider Name (Legal Business Name): NATHAN RICHARD HEPPERMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6955 HOSPITAL DR
DUBLIN OH
43016-8580
US

IV. Provider business mailing address

4441 LOWESTONE RD
COLUMBUS OH
43220-4259
US

V. Phone/Fax

Practice location:
  • Phone: 614-689-3401
  • Fax:
Mailing address:
  • Phone: 636-357-3992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019604
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: