Individual provider Active NPI

William Lenox Heimer II, M.D.

  • Procedural Dermatology Physician
  • Encinitas, CA
National Provider Identifier
1225147481
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
G85498 Issued in CA
Practice address
320 Santa Fe Drive
Suite 310
Encinitas, CA 92024-5138
Phone
(760) 944-7000
Fax
(760) 944-1556
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X G85498 CA Primary

Addresses

Primary practice location

320 Santa Fe Drive
Suite 310
Encinitas, CA 92024-5138

Mailing address

320 Santa Fe Dr
Suite 310
Encinitas, CA 92024-5138
Phone (760) 944-7000

Other identifiers 2

IdentifierTypeStateIssuer
00G854980OtherBLUE CROSS/BLUE SHIELD
330900346OtherTRICARE

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

LicenseStateTypeSpecialty
85498CAMDMarriage & Family Therapist
G85498CAMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert B. Rhoades MD, PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1225147481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR",
            "address_2": "SUITE 310",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "760-944-7000",
            "fax_number": "760-944-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DRIVE",
            "address_2": "SUITE 310",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "760-944-7000",
            "fax_number": "760-944-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMER",
        "first_name": "WILLIAM",
        "middle_name": "LENOX",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G85498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00G854980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "330900346",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.