NPIMap

Organization Active NPI

Heinen Medical Clinics LLC

  • Rural Health Clinic/Center
  • Eunice, LA
National Provider Identifier
1124593900
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HEINEN MEDICAL CLINICS LLC
Practice address
151 Leon Ave Ste B
Eunice, LA 70535-3938
Phone
(337) 457-8166
Fax
(888) 371-3069
NPI assigned
Oct 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Jade Nicholas Heinen, MDNPI 1174732424
Title
Ceo
Phone
(337) 457-8166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

151 Leon Ave Ste B
Eunice, LA 70535-3938

Mailing address

151 Leon Ave
Eunice, LA 70535-3937
Phone (337) 457-8166

Other names 1

  • Heinen Medical Eunice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190522002483 LA Part A Provider - Rural Health Clinic 9739422304 Practice locations: Eunice, LA
O20210924001137 LA Part B Supplier - Clinic/Group Practice 9739422304 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Eunice, LA; Kinder, LA; Ville Platte, LA

Rural health clinic certification: CCN 193956

Legal name
HEINEN MEDICAL CLINICS LLC
Doing business as
HEINEN MEDICAL EUNICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 31, 2020
Last certification
Mar 31, 2023
Ownership / control type
1C
Organization structure
LLCProprietary
Incorporated
Aug 29, 2018 in LA
Enrollment address
151 Leon Ave
Ste B
Eunice, LA 70535-3938

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jade N Heinen Individual 5% Or Greater Direct Ownership InterestChief Operations Officer Aug 29, 2018 50%
General Partnership InterestChief Operations Officer Aug 29, 2018 50%
Corporate OfficerChief Operations Officer Aug 29, 2018 50%
Operational/Managerial ControlChief Operations Officer Aug 29, 2018 50%
Brian N Heinen Individual 5% Or Greater Direct Ownership InterestPresident Aug 29, 2018 50%
General Partnership InterestPresident Aug 29, 2018 50%
Corporate OfficerPresident Aug 29, 2018 50%
Operational/Managerial ControlPresident Aug 29, 2018 50%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Brian N. Heinen, M.D.
    • Family Medicine Physician
    • Eunice, LA
    • NPI 1457362899

    5% Or Greater Direct Ownership Interest, Corporate Officer, General Partnership Interest, Operational/Managerial Control

    CMS ownership
  • Jade Nicholas Heinen, M.D.
    • Family Medicine Physician
    • Eunice, LA
    • NPI 1174732424

    5% Or Greater Direct Ownership Interest, Corporate Officer, General Partnership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1124593900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 LEON AVE",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353937",
            "telephone_number": "337-457-8166",
            "fax_number": "888-371-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 LEON AVE STE B",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353938",
            "telephone_number": "337-457-8166",
            "fax_number": "888-371-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEINEN MEDICAL CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "HEINEN",
        "authorized_official_first_name": "JADE",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-457-8166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heinen Medical Eunice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eunice, LA

Sources for this page

Verify at the official NPI Registry.