Active NPI
Shirley Heatley, RN
- Registered Nurse
- Portland, ME
National Provider Identifier
1114043056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R014002
- Practice address
- 134 Congress St
Portland, ME 04101 - Phone
- (207) 874-8784
- NPI assigned
- Mar 22, 2007
- Last updated
- Jul 9, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R014002 | ME | Primary |
Addresses
Primary practice location
134 Congress St
Portland, ME 04101
Mailing address
389 Congress St
Room 307
Portland, ME 04101-3509
Phone (207) 874-8784
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R014002 | ME | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Portland | 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, 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": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1114043056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "389 CONGRESS ST",
"address_2": "ROOM 307",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041013509",
"telephone_number": "207-874-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 CONGRESS ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-874-8784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATLEY",
"first_name": "SHIRLEY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ME",
"license": "R014002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.