Active NPI
Joel C Heinzen
- Family Medicine Physician
- Yakima, WA
National Provider Identifier
1174593214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00014515
- Practice address
- 12 S 8TH St
Yakima, WA 98901-3020 - Phone
- (509) 454-4143
- Fax
- (509) 454-3651
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00014515 | WA | Primary |
Addresses
Primary practice location
12 S 8TH St
Yakima, WA 98901-3020
Mailing address
PO Box 2605
Yakima, WA 98907-2605
Phone (509) 454-4143
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G8877276 | Other | WA | PTAN |
| 8290603 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014515 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1174593214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2605",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989072605",
"telephone_number": "509-454-4143",
"fax_number": "509-454-3651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 S 8TH ST",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989013020",
"telephone_number": "509-454-4143",
"fax_number": "509-454-3651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINZEN",
"first_name": "JOEL",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00014515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "G8877276",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8290603",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.