Individual provider Active NPI

Barbara Ann-Marie Heerkens

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1083479075
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86289105 Issued in AZ
Practice address
34225 N 27TH Dr # 1465
Phoenix, AZ 85085-6087
Phone
(602) 932-1212
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86289105 AZ Primary

Addresses

Primary practice location

34225 N 27TH Dr # 1465
Phoenix, AZ 85085-6087

Mailing address

12691 W Smokey Dr Ste 127
Surprise, AZ 85378-3801
Phone (602) 810-1210

Other practice location 1

12691 W Smokey Dr Ste 127
Surprise, AZ 85378-3801
Phone (602) 810-1210

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

LicenseStateTypeSpecialty
86289105AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Health Loft Services LLC Dietitian, Registered Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1083479075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12691 W SMOKEY DR STE 127",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783801",
            "telephone_number": "602-810-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DR # 1465",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856087",
            "telephone_number": "602-932-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12691 W Smokey Dr Ste 127",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853783801",
            "country_code": "US",
            "telephone_number": "602-810-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERKENS",
        "first_name": "BARBARA",
        "middle_name": "ANN-MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86289105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.