Heidi Jean Gonzalez

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11040-146 Issued in WI

Practice address

12100 W Dearbourn Ave
Wauwatosa, WI 53226-3840

Phone

(414) 870-3548

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1194466029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 S 111TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532142331",
            "telephone_number": "414-456-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 W DEARBOURN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263840",
            "telephone_number": "414-870-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "HEIDI",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "11040-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Milwaukee",
            "affiliation": "N",
            "address_1": "12100 W Dearbourn Ave",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532263840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Wauwatosa",
            "affiliation": "N",
            "address_1": "12100 W Dearbourn Ave",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532263840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gold Standard Home Healthcare
• Shiloh Joshua Golden, DMD
• Samuel Goldner, DPT
• Jill Marie Goldsworthy, LCSW
• Kerri Lynn Golinghorst, MD
• Jennifer L Good, MD
• Carrie Beth Goodman, L.P.N.
• Kenneth B. Gordon, M.D.
• Nicholas Gore, PA-C
• Melissa Gorman

• Massage Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.