Jon E Heitzman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-495 Issued in ID

Practice address

2680 S Lincoln Ave
Jerome, ID 83338-6128

Phone

(208) 324-4333

NPI assigned

Aug 15, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jon.heitzman@direct.revolutionehr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Idaho Vision Alliance,PLLC

  • Optometrist
  • Twin Falls, ID
  • NPI 1427169416
  NPD (past) Authorized official
• Cheaper Peepers LLC

  • Optometrist
  • Twin Falls, ID
  • NPI 1598863029
  NPD (past)
• Mountain West Optical Inc

  • Optometrist
  • Twin Falls, ID
  • NPI 1902810757
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194838375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 TRAIL CREEK CIR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018352",
            "telephone_number": "208-734-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833386128",
            "telephone_number": "208-324-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "JON",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8041644",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert William Hale, DMD
• Yudith Hall
• Joshua Ted Hansen, D.O.
• Sandra Jean Harney, MT
• Jonathan Harper, BA, MA
• Ronald Gail Hendrickson, DDS
• Adena Ursula Henry
• Kaleb Mikal Henson
• Heritage Academy
• Adam James Hill, PHARM D

• Optometrist in Jerome, ID
• Providers in Jerome, ID by specialty
• Optometrist in Idaho

• 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.