Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jeremy Wayne Hegman, DPT

Individual provider Physical Therapist · NPI 1215537196

Mr. Jeremy Wayne Hegman, DPT is a Physical Therapist in Private Practice in Pocatello, Idaho. Qualified in 2020, 6 years ago. Practices with Specialized Physical Therapy PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4141 Poleline Rd Ste A
Pocatello, ID 83202-4904
Phone: (208) 242-8617
Fax: (833) 608-2470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-6704 (ID)

Record details

NPI number1215537196
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 29, 2020
Last updated in NPPESOctober 19, 2023
Certification dateOctober 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Specialized Physical Therapy Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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