Individual provider Active NPI

Brandy Marie Heinrich, FNP BC

  • Acute Care Nurse Practitioner
  • Jennings, LA
National Provider Identifier
1104107630
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP06539 Issued in LA
Practice address
1750 Elton Rd
Jennings, LA 70546-3632
Phone
(337) 329-6565
Fax
(337) 329-6575
NPI assigned
Aug 29, 2011
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP06539 LA Primary
Family Nurse Practitioner 363LF0000X AP06539 LA

Addresses

Primary practice location

1750 Elton Rd
Jennings, LA 70546-3632

Mailing address

1750 Elton Rd
Jennings, LA 70546-3632
Phone (337) 329-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150715001832 LA Practitioner - Nurse Practitioner 1456664754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06539LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care, LLC CurrentSince Sep 30, 2024 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Sep 30, 2024 Accepting new patients

Locations

1750 Elton Rd
Jennings, LA 70546
Phone (337) 329-6565

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1104107630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463632",
            "telephone_number": "337-329-6565",
            "fax_number": "337-329-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463632",
            "telephone_number": "337-329-6565",
            "fax_number": "337-329-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINRICH",
        "first_name": "BRANDY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP06539",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

Verify at the official NPI Registry.