Robert Heinemann

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

CGC058989 Issued in FL

Practice address

2401 Oak Dr
Longwood, FL 32779-4745

Phone

(407) 595-5457

Fax

(407) 772-0378

NPI assigned

May 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dann Heinemann Professional name

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1336596386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161941",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161941",
            "telephone_number": "407-595-5457",
            "fax_number": "407-772-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 OAK DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794745",
            "telephone_number": "407-595-5457",
            "fax_number": "407-772-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINEMANN",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "FL",
            "license": "CGC058989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691368779",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANN",
            "last_name": "HEINEMANN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Home Modifications Contractor in Longwood, FL
• Providers in Longwood, FL by specialty
• Home Modifications Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.