Brian Francis Heatherton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.006614 Issued in IL

Practice address

Psychiatric Associates of Central Illinois
1124 S. Sixth Street
Springfield, IL 62703

Phone

(217) 523-3143

Fax

(217) 523-7695

NPI assigned

Jul 25, 2006

Last updated

Aug 9, 2022By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Associates of Central Illinois LTDGroup PAC ID 1355318825, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1376698050
  Medicare reassignment Care Compare group NPD
• Bromenn Physicians Management Corporation

  dba Advocate Medical Group Bromenn

  • Family Medicine Physician
  • Normal, IL
  • NPI 1285903799

  Professional

  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1235152901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PSYCHIATRIC ASSOCIATES OF CENTRAL ILLINOIS",
            "address_2": "1124 S. SIXTH STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62703",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PSYCHIATRIC ASSOCIATES OF CENTRAL ILLINOIS",
            "address_2": "1124 S. SIXTH STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62703",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHERTON",
        "first_name": "BRIAN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "071006614",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.006614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05732028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanteria Heard-Phillips
• Heart 4 Heart Inc (Personal Mobility)
• Heart 4 Heart Inc. (Personal Mobility)
• Heartland Hearing, Inc
• Heartland Naprapathic Center LTD
• June F Heberling, CRNA
• Madeleine D Heckenkamp, APRN, CNP
• Parker Laurance Heger, MD
• Jessica Lynne Heil, MSN, FNP-C
• Tonya L. Heim, FNP

• Clinical Psychologist in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.