Active NPI
Douglas Jon Heintz, M.D.
- Family Medicine Physician
- Rapid City, SD
National Provider Identifier
1275873606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0977
- Practice address
- 2507 Thames Cir
Rapid City, SD 57702-5305 - Phone
- (605) 348-9501
- NPI assigned
- Feb 21, 2013
- Last updated
- Feb 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 0977 | SD | Primary |
Addresses
Primary practice location
2507 Thames Cir
Rapid City, SD 57702-5305
Mailing address
2507 Thames Cir
Rapid City, SD 57702-5305
Phone (605) 348-9501
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0977 | SD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1275873606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2507 THAMES CIR",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577025305",
"telephone_number": "605-348-9501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2507 THAMES CIR",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577025305",
"telephone_number": "605-348-9501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINTZ",
"first_name": "DOUGLAS",
"middle_name": "JON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-21",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SD",
"license": "0977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.