Susan E. Heckley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000511A Issued in IN

Practice address

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Phone

(260) 432-2297

Fax

(260) 434-6496

NPI assigned

Jun 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1154617850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKLEY",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000511A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050703",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200239090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Vaughn Heatwole, MD
• Lisa A. Heck, M.A.
• Robert Paul Heck, PH.D
• Sarah D Heck, FNP
• Clare Ann Coddington Heckathorn, PA-C
• Erin Elizabeth Heckman, COTA
• Hector F Perez MD PC
• Jamie A Hedman, MD
• William P Hedrick, M.D.
• John Heemstra, M.D.

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.