Active NPI
Nan Shirley Heinbaugh
- Clinical Psychologist
- Burlington, NC
National Provider Identifier
1093798761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0519
- Practice address
- 108 W Kime St
Burlington, NC 27215-3854 - Phone
- (336) 228-8530
- NPI assigned
- Nov 27, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0519 | NC | Primary |
Addresses
Primary practice location
108 W Kime St
Burlington, NC 27215-3854
Mailing address
108 W Kime St
Burlington, NC 27215-3854
Phone (336) 228-8530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100820000826 | NC | Practitioner - Clinical Psychologist | 4284768680 | Practice locations: Burlington, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
108 W Kime St
Burlington, NC 27215-3854
Phone (336) 228-8530
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0519 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1093798761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 W KIME ST",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272153854",
"telephone_number": "336-228-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W KIME ST",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272153854",
"telephone_number": "336-228-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINBAUGH",
"first_name": "NAN",
"middle_name": "SHIRLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "0519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.