Individual provider Active NPI

Jessica Nicole Heis, APRN, FNP-C

  • Nurse Practitioner
  • Beckley, WV
National Provider Identifier
1295380822
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
103705 Issued in WV
Practice address
124 Brookshire LN
Beckley, WV 25801-6761
Phone
(304) 252-8551
Fax
(304) 461-0435
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 103705 WV Primary

Addresses

Primary practice location

124 Brookshire LN
Beckley, WV 25801-6761

Mailing address

252 Rural Acres Dr
Beckley, WV 25801-3503
Phone (304) 253-2628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20200317000494 WV Practitioner - Nurse Practitioner 6507294014 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
103705WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Emergency Services, Inc. Nurse Practitioner CurrentSince Apr 6, 2024 Accepting new patients
Cherokee Emergency Services, Inc. Nurse Practitioner CurrentSince Feb 5, 2020 Accepting new patients

Locations

124 Brookshire Ln
Beckley, WV 25801
Phone (304) 252-8551

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Interoperability endpoints

  • Direct secure messaging: jessica.heis.1@14333.direct.athenahealth.com

Organizations & group practices 2

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1295380822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-253-2628",
            "fax_number": "304-252-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 BROOKSHIRE LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016761",
            "telephone_number": "304-252-8551",
            "fax_number": "304-461-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIS",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "103705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.