Individual provider Active NPI

Nancy E. Heilman, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Puyallup, WA
National Provider Identifier
1326263039
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
2063 Issued in WA
Practice address
319 5TH St SW
Puyallup, WA 98371-5828
Phone
(253) 640-8163
Fax
(253) 841-1397
NPI assigned
Apr 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 2063 WA Primary

Addresses

Primary practice location

319 5TH St SW
Puyallup, WA 98371-5828

Mailing address

319 5TH St SW
Puyallup, WA 98371-5828
Phone (253) 640-8163

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 Philosophy

State licenses

LicenseStateTypeSpecialty
2063WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Ida Karlin Pediatric Center PastSince Oct 10, 2010 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326263039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 5TH ST SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715828",
            "telephone_number": "253-640-8163",
            "fax_number": "253-841-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 5TH ST SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715828",
            "telephone_number": "253-640-8163",
            "fax_number": "253-841-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "NANCY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "2063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.