Justin Blaine Heyrend, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28260685A Issued in IN

Practice address

10315 Dawsons Creek Blvd Ste Ab
Fort Wayne, IN 46825-1912

Phone

(260) 436-7875

Fax

(260) 432-9812

NPI assigned

Jul 16, 2020

Last updated

May 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101

Merit-based Incentive Payment System (MIPS)

Final score

67.76 of 100Reported as group

Quality

62.07

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinical Colleagues LLC

  • Anesthesiology Physician
  • Van Wert, OH
  • NPI 1992725766

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Cameron Memorial Community Hospital, Inc

  dba Cameron Anesthesiology

  • Family Medicine Physician
  • Angola, IN
  • NPI 1770521478
  Medicare reassignment NPD
• Cameron Memorial Community Hospital, Inc.

  • Critical Access Hospital
  • Angola, IN
  • NPI 1386683316
  NPD
• U S Anesthesia Partners of Kentucky PSC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1144901042

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Whitley Memorial Hospital, Inc.

  dba Parkview Whitley Hospital

  • General Acute Care Hospital
  • Columbia City, IN
  • NPI 1205844495
  Care Compare affiliation
• Whitley Memorial Hospital, Inc.

  dba Parkview Whitley Hospital

  • Land Ambulance
  • Columbia City, IN
  • NPI 1497764450

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1316555246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE AB",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYREND",
        "first_name": "JUSTIN",
        "middle_name": "BLAINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2023-05-18",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28260685A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28260685A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.lutheranhospital.com/",
            "affiliation": "Y",
            "affiliationName": "Lutheran Health Network",
            "address_1": "700 Broadway",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468021402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber R Hetrick, M.D.
• Brittney L Hetrick, NP
• Michael Joseph Hetrick, BC-HIS
• Kelly Hey-Miller, PHARMD
• Angel Nicole Heyerly, PHARMD
• Myah Nicole Hibbard-Casault
• David D Hibish
• Eric James Hick, D.O.
• Kathleen Hickey, CD(DONA)
• Benjamin Matthew Hicks, M.D.

• Certified Registered Nurse Anesthetist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.