Katie Heinz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008843 Issued in MI

Practice address

1661 Crystal Springs Blvd SE
Caledonia, MI 49316-7478

Phone

(616) 326-0114

Fax

(616) 369-3790

NPI assigned

Nov 19, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1285103317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 CRYSTAL SPRINGS BLVD SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167478",
            "telephone_number": "616-326-0114",
            "fax_number": "616-369-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 CRYSTAL SPRINGS BLVD SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167478",
            "telephone_number": "616-326-0114",
            "fax_number": "616-369-3790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Union Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Commerce Township",
            "state": "MI",
            "postal_code": "483823500",
            "country_code": "US",
            "telephone_number": "248-250-6431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "KATIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Caledonia, MI
• Providers in Caledonia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.