Active NPI
Jennifer Rebecca Heimall, MD
- Pediatric Allergy/Immunology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Allergy/Immunology Physician
- License
- MD440044
- Practice address
- 3550 Market St FL 3
Childrens Hospital of Philadelphia - Allergy and Immun
Philadelphia, PA 19104-3365 - Phone
- (215) 590-2549
- Fax
- (215) 590-4529
- NPI assigned
- Jun 29, 2007
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD440044 | PA | |
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | 25MA07835700 | NJ | |
| Pediatrics Physician | 208000000X | 25MA07835700 | NJ | |
| Pediatrics Physician | 208000000X | MD440044 | PA | |
| Pediatric Allergy/Immunology Physician | 2080P0201X | MD440044 | PA | Primary |
Addresses
Primary practice location
3550 Market St FL 3
Childrens Hospital of Philadelphia - Allergy and Immun
Philadelphia, PA 19104-3365
Mailing address
100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07835700 | NJ | MD | Allergy & Immunology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Pediatric Allergy/Immunology | Current | Accepting new patients |
| Childrens Health Care Associates, Inc | Pediatrics | Current | Accepting new patients |
| Childen'S Health Care Associates Inc. | Current | Accepting new patients | |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Locations
100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232
3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169
3550 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 590-2549
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1598869059
-
- Pediatric Registered Nurse
- Philadelphia, PA
- NPI 1699860643
-
- Pediatric Allergy/Immunology Physician
- Philadelphia, PA
- NPI 1720173776
-
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365984000000",
"number": "1104023316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ",
"address_2": "9TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073323",
"telephone_number": "267-425-9234",
"fax_number": "267-425-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 MARKET ST FL 3",
"address_2": "CHILDRENS HOSPITAL OF PHILADELPHIA - ALLERGY AND IMMUN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043365",
"telephone_number": "215-590-2549",
"fax_number": "215-590-4529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIMALL",
"first_name": "JENNIFER",
"middle_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2013-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "PA",
"license": "MD440044",
"primary": false
},
{
"code": "207RA0201X",
"taxonomy_group": "",
"desc": "Internal Medicine, Allergy & Immunology",
"state": "NJ",
"license": "25MA07835700",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA07835700",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD440044",
"primary": false
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "PA",
"license": "MD440044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.