Mitchell Heimlich

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

10142 Keppler Dr
San Diego, CA 92124-2504

Phone

(719) 322-3128

NPI assigned

Oct 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1144984212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10142 KEPPLER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242504",
            "telephone_number": "719-322-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10142 KEPPLER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242504",
            "telephone_number": "719-322-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMLICH",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-26",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Heim, DPT
• Kristy Jo Heiman
• Jared Heath Heimbigner, D.O.
• Lauren Heimerdinger, OTD, OTR/L
• Graham Heimler, MD
• Joanne Gerstein Hein, MS, CCC-SLP
• Mary Ivey Heineke, LMFT53044
• Michael Heineman
• Thomas C Heineman, MD, PHD
• Brad D Heiner, PHARM.D.

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.