Gary Dennis Heins, LICENSED OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LO-# 715 Issued in CT

Practice address

117 Washington Ave
North Haven, CT 06473-1769

Phone

(203) 239-6172

Fax

(203) 239-0295

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1033241997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731769",
            "telephone_number": "203-239-6172",
            "fax_number": "203-239-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731769",
            "telephone_number": "203-239-6172",
            "fax_number": "203-239-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINS",
        "first_name": "GARY",
        "middle_name": "DENNIS",
        "credential": "LICENSED OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "LO-# 715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC--NUMBER",
            "identifier": "0648180001",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX",
            "identifier": "61-1442432",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER",
            "identifier": "100000715CT-01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optician in North Haven, CT
• Providers in North Haven, CT by specialty
• Optician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.