Heidi Marie Kinnally, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F401384-1 Issued in NY

Practice address

1045 James St
Syracuse, NY 13203-2730

Phone

(315) 472-4471

Fax

(315) 472-1759

NPI assigned

Sep 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heidi Marie Prong Other name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Liberty Resources Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Syracuse, NY
  • NPI 1225254881
  Medicare reassignment Care Compare group NPD
• Northern Oswego County Health Services, Inc.

  • Community Health Clinic/Center
  • Pulaski, NY
  • NPI 1508850280
  Medicare reassignment NPD
• Upstate Psychiatry, PC

  • Psychiatry Physician
  • Baldwinsville, NY
  • NPI 1184170821
  Medicare reassignment
• Liberty Resources, Inc.

  • Substance Abuse Rehabilitation Facility
  • Syracuse, NY
  • NPI 1639729452
  NPD
• Liberty Resources, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, NY
  • NPI 1700688827
  NPD

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1245512284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471",
            "fax_number": "315-472-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471",
            "fax_number": "315-472-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNALLY",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401384-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "PRONG",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha King, FNP
• Fawn Lee Kingsbury, LPN
• Roselynn Knapp Kingsbury, APRN, BC
• Chelsea Kingsley, RDN
• Virginia Kingsley, LMHC
• Jesse Kinner, DO
• Anna Blanche Kinney
• Mara T Kinney, MS
• Margaret B. Kinney, RDH
• Desiree Kinnison, NP

• Psychiatric/Mental Health Nurse Practitioner in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.