Thomas William Heitkemper, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4086 Issued in OH

Practice address

1550 Yankee Park PL
Ste a
Centerville Finance, OH 45458-1868

Phone

(937) 439-4949

Fax

(937) 439-4948

NPI assigned

Jan 9, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164571576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 YANKEE PARK PL",
            "address_2": "STE A",
            "city": "CENTERVILLE FINANCE",
            "state": "OH",
            "postal_code": "454581868",
            "telephone_number": "937-439-4949",
            "fax_number": "937-439-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 YANKEE PARK PL",
            "address_2": "STE A",
            "city": "CENTERVILLE FINANCE",
            "state": "OH",
            "postal_code": "454581868",
            "telephone_number": "937-439-4949",
            "fax_number": "937-439-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITKEMPER",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0934261",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Centerville Finance, OH
• Providers in Centerville Finance, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.