Active NPI
Clifford W Heinrich, DO
- Family Medicine Physician
- Phoenix, AZ
National Provider Identifier
1215020516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3295
- Practice address
- 2211 E Highland Avenue
#105
Phoenix, AZ 85016-4833 - Phone
- (602) 954-1502
- Fax
- (602) 954-1504
- NPI assigned
- Oct 2, 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 | 3295 | AZ | Primary |
Addresses
Primary practice location
2211 E Highland Avenue
#105
Phoenix, AZ 85016-4833
Mailing address
3031 W Northern Avenue
Suite 111
Phoenix, AZ 85051-6695
Phone (602) 347-0873
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3295 | AZ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Community Care | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BAFJCA
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Phoenix, AZ
- NPI 1104929504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215020516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3031 W NORTHERN AVENUE",
"address_2": "SUITE 111",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850516695",
"telephone_number": "602-347-0873",
"fax_number": "602-246-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 E HIGHLAND AVENUE",
"address_2": "#105",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850164833",
"telephone_number": "602-954-1502",
"fax_number": "602-954-1504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINRICH",
"first_name": "CLIFFORD",
"middle_name": "W",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "3295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.