Individual provider Active NPI

Cynthia Heiserman, D.C.

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1023103694
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2191 Issued in MN
Practice address
3511 Emerson Avenue North
Minneapolis, MN 55412-2522
Phone
(612) 529-2218
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2191 MN Primary

Addresses

Primary practice location

3511 Emerson Avenue North
Minneapolis, MN 55412-2522

Mailing address

3511 Emerson Avenue North
Minneapolis, MN 55412-2522
Phone (612) 529-2218

Other identifiers 2

IdentifierTypeStateIssuer
OC363HEOtherMNBCBS INDIVIDUAL PROVIDER
06921HEOtherMNBCBS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050505000948 MN Practitioner - Chiropractic 7214977511 Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023103694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 EMERSON AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122522",
            "telephone_number": "612-529-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 EMERSON AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122522",
            "telephone_number": "612-529-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISERMAN",
        "first_name": "CYNTHIA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PROVIDER",
            "identifier": "OC363HE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "06921HE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.