Bryce W Heinzen, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6717-26 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 433-7822

Fax

(920) 433-3651

NPI assigned

Apr 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1164043394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-7822",
            "fax_number": "920-433-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 Shawano Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543033216",
            "country_code": "US",
            "telephone_number": "920-499-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZEN",
        "first_name": "BRYCE",
        "middle_name": "W",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6717-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Evan Hein, M.D.
• Steven R Hein, D.D.S.
• Rachele Heinrich, MA CCC-SLP
• Amber Leigh Heinz, MS/CCC-SLP
• Samantha M Heinz, CST
• Maryjo Leigh Heise, APNP
• Lisa M Hekenberger, RDH
• Valorie Anne Helander, LCSW
• Amy Helein, NAC, LPCIT
• Brenda Hella

• Occupational Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.