Active NPI
David Edward Heffken, COTA/L
- Occupational Therapy Assistant
- Huntsville, AL
National Provider Identifier
1063708139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3118
- Practice address
- 4831 Kyle LN NW
Huntsville, AL 35810-3011 - Phone
- (256) 777-5100
- NPI assigned
- Jun 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3118 | AL | Primary |
Addresses
Primary practice location
4831 Kyle LN NW
Huntsville, AL 35810-3011
Mailing address
4831 Kyle LN NW
Huntsville, AL 35810-3011
Phone (256) 777-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3118 | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309132800000",
"number": "1063708139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4831 KYLE LN NW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358103011",
"telephone_number": "256-777-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4831 KYLE LN NW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358103011",
"telephone_number": "256-777-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEFFKEN",
"first_name": "DAVID",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-27",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AL",
"license": "3118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.