Active NPI
Sidney Heisler, MD
- Psychiatry Physician
- Marshall, MI
National Provider Identifier
1194740118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301055220
- Practice address
- 15209 W Michigan Ave
Marshall, MI 49068-9570 - Phone
- (269) 781-9119
- NPI assigned
- Jul 12, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301055220 | MI | Primary |
Addresses
Primary practice location
15209 W Michigan Ave
Marshall, MI 49068-9570
Mailing address
15209 W Michigan Ave
Marshall, MI 49068-9570
Phone (269) 781-9119
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104699766 | Medicaid | MI | |
| 7509107630 | Other | MI | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 4301055220 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361232000000",
"number": "1194740118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15209 W MICHIGAN AVE",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490689570",
"telephone_number": "269-781-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15209 W MICHIGAN AVE",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490689570",
"telephone_number": "269-781-9119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISLER",
"first_name": "SIDNEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2013-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301055220",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104699766",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7509107630",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.