Provider Demographics
NPI:1477542454
Name:HEIPLE, JYOTI J (OTR L)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:J
Last Name:HEIPLE
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:JYOTI
Other - Middle Name:J
Other - Last Name:KHIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 740041
Mailing Address - Street 2:DEPT 6150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-7441
Mailing Address - Country:US
Mailing Address - Phone:502-562-0398
Mailing Address - Fax:502-585-0021
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 650
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1888
Practice Address - Country:US
Practice Address - Phone:502-562-0398
Practice Address - Fax:502-585-0021
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2395225X00000X, 225XH1200X
IN31003219A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000600607OtherBCBS FOR LHT
KY000000600607OtherBCBS FOR LHT