Active NPI
Mark A Heinold
- Pharmacist
- Madison, WI
National Provider Identifier
1336318641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15117
- Practice address
- 600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001 - Phone
- (608) 662-0817
- NPI assigned
- Feb 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15117 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001
Mailing address
2806 Warner St
Madison, WI 53713-2161
Phone (219) 508-0143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15117 | Other | WI | PHARMACIST |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15117 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204502400000",
"number": "1336318641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2806 WARNER ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537132161",
"telephone_number": "219-508-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"address_2": "COMPLIANCE MAIL CODE 2433",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "608-662-0817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINOLD",
"first_name": "MARK",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-21",
"last_updated": "2008-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "15117",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "15117",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.