NPIMap

Individual provider Active NPI

Heidi Jo Muncy, PA

  • Physician Assistant
  • Westminster, CO
National Provider Identifier
1073615001
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
626 Issued in CO
Practice address
7625 W 92ND Ave
Westminster, CO 80021-4567
Phone
(303) 427-4075
Fax
(303) 423-4185
NPI assigned
Sep 1, 2006
Last updated
May 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 626 CO Primary

Addresses

Primary practice location

7625 W 92ND Ave
Westminster, CO 80021-4567

Mailing address

7625 W 92ND Ave
Westminster, CO 80021-4567
Phone (303) 427-4075

Other identifiers 1

IdentifierTypeStateIssuer
P00893501OtherCORAIL ROAD MEDICARE

Other names 1

  • Heidi Jo Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103000476 CO Practitioner - Physician Assistant 3375561806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

2055 W 136TH Ave Unit
B118 Quail Creek Clinic
Broomfield, CO 80023-9308
Phone (303) 673-1570

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
626COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 1, 2015 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 1, 2015 Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients
Apex Emergency Group, Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1073615001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800214567",
            "telephone_number": "303-427-4075",
            "fax_number": "303-423-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800214567",
            "telephone_number": "303-427-4075",
            "fax_number": "303-423-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCY",
        "first_name": "HEIDI",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00893501",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "DAVIS",
            "middle_name": "JO",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.