NPIMap

Individual provider Active NPI

James T Heiberger, MD

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1336238930
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24223 Issued in CO
Practice address
1304 N Academy Blvd
106
Colorado Springs, CO 80909
Phone
(719) 638-4548
Fax
(719) 638-4571
NPI assigned
Oct 12, 2006
Last updated
May 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24223 CO Primary

Addresses

Primary practice location

1304 N Academy Blvd
106
Colorado Springs, CO 80909

Mailing address

1304 N Academy Blvd
106
Colorado Springs, CO 80909
Phone (719) 638-4548

Other identifiers 2

IdentifierTypeStateIssuer
080001911OtherCOR.R.MEDICARE
01242239MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927001450 CO Practitioner - Family Practice 9537194618 Practice locations: Colorado Springs, CO

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Medical Clinic LLCGroup PAC ID 5991117640, 3 clinicians

Practice addresses (Care Compare)

3604 Galley Rd
Suite 201
Colorado Springs, CO 80909-4301
Phone (719) 638-4548

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24223COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Medical Clinic, LLC Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Colorado Community Clinic Inc PastSince Jul 17, 2018 Accepting new patients

Locations

3604 Galley Rd
Ste 201
Colorado Springs, CO 80909
Phone (719) 634-4548

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

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1336238930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N ACADEMY BLVD",
            "address_2": "106",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-638-4548",
            "fax_number": "719-638-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N ACADEMY BLVD",
            "address_2": "106",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-638-4548",
            "fax_number": "719-638-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIBERGER",
        "first_name": "JAMES",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "24223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R.MEDICARE",
            "identifier": "080001911",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01242239",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.