Active NPI
Diane Dawn Heasley, DO
- Anatomic Pathology & Clinical Pathology Physician
- Denver, CO
National Provider Identifier
1073582672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 35520
- Practice address
- 6116 E Warren Ave
Denver, CO 80222-5703 - Phone
- (303) 512-0888
- Fax
- (303) 512-2288
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology (Pathology) Physician | 207ZD0900X | 35520 | CO | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 35520 | CO | Primary |
Addresses
Primary practice location
6116 E Warren Ave
Denver, CO 80222-5703
Mailing address
103 Continental PL
Ste 400
Brentwood, TN 37027-1073
Phone (615) 916-3200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 641789 | Medicaid | AZ | |
| Z7622 | Medicaid | NM | |
| 01355205 | Medicaid | CO | |
| Z0237 | Medicaid | UT |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35520 | CO | MD | Dermatopathology (Pathology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1073582672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CONTINENTAL PL",
"address_2": "STE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370271073",
"telephone_number": "615-916-3200",
"fax_number": "615-658-8389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6116 E WARREN AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802225703",
"telephone_number": "303-512-0888",
"fax_number": "303-512-2288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEASLEY",
"first_name": "DIANE",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "CO",
"license": "35520",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CO",
"license": "35520",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "641789",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z7622",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01355205",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z0237",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.