Individual provider Active NPI

Susan J. Wegelt Heinz, CNM, NP

  • Advanced Practice Midwife
  • Corvallis, OR
National Provider Identifier
1144266362
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
087006416RN/N5 Issued in OR
Practice address
2314 NW Kings Blvd
Ste a
Corvallis, OR 97330-3925
Phone
(541) 286-4030
Fax
(541) 286-4158
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 087006416RN/N5 OR Primary

Addresses

Primary practice location

2314 NW Kings Blvd
Ste a
Corvallis, OR 97330-3925

Mailing address

2314 NW Kings Blvd
Ste a
Corvallis, OR 97330-3925
Phone (541) 286-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040825000340 OR Practitioner - Nurse Practitioner 7618941626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
087006416RN/N5ORMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Corvallis Birth and Womens Health Center CurrentSince May 1, 2016 Accepting new patients
Heart of the Valley Gynecology and Sexual Health Advanced Practice Midwife Current Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation PastSince Sep 1, 2004 Accepting new patients

Locations

2211 NW Professional Dr
Ste 202
Corvallis, OR 97330
Phone (541) 919-5778

2314 NW Kings Blvd
#A
Corvallis, OR 97330
Phone (541) 286-4030

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1144266362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 NW KINGS BLVD",
            "address_2": "STE A",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-286-4030",
            "fax_number": "541-286-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 NW KINGS BLVD",
            "address_2": "STE A",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-286-4030",
            "fax_number": "541-286-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGELT HEINZ",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "CNM, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "087006416RN/N5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.