Active NPI
Kadin Heisey, RPH
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1336864990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP456035
- Practice address
- 1051 South St
Philadelphia, PA 19147-1997 - Phone
- (215) 829-0670
- NPI assigned
- Oct 6, 2022
- 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 | RP456035 | PA | Primary |
Addresses
Primary practice location
1051 South St
Philadelphia, PA 19147-1997
Mailing address
1051 South St
Philadelphia, PA 19147-1910
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP456035 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1336864990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1051 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471997",
"telephone_number": "215-829-0670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISEY",
"first_name": "KADIN",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-06",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP456035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.