Kelly C Heinze

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1661 Issued in ND

Practice address

205 2ND Ave NE
Garrison, ND 58540-7168

Phone

(701) 463-2213

NPI assigned

Sep 4, 2018

Last updated

Sep 4, 2018By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1306328596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 45TH AVE NW LOT 3",
            "city": "GARRISON",
            "state": "ND",
            "postal_code": "585409420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 2ND AVE NE",
            "city": "GARRISON",
            "state": "ND",
            "postal_code": "585407168",
            "telephone_number": "701-463-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 5th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Garrison",
            "state": "ND",
            "postal_code": "585407348",
            "country_code": "US",
            "telephone_number": "701-463-2213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZE",
        "first_name": "KELLY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrison-Max Ambulance District
• Denise Marie Gradin, PT
• Luanna Graeber, PA-C
• Ann Hagen-Reinholt, PT
• Vern Allen Harchenko, MD
• Forrest Leroy Hirsch, FNP-C
• Heather Leah Hunt, DPT
• Tammy K Iglehart, PT, ATC
• Kelly Chiropractic, PC
• Lakeview Chiropractic

• Speech-Language Pathologist in Garrison, ND
• Providers in Garrison, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.