Individual provider Active NPI

Brandy Dawn Heaton, FNP-C APRN

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1346719291
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP54278 Issued in NM
Practice address
4801 McMahon Blvd NW Ste 245
Albuquerque, NM 87114-5478
Phone
(505) 315-3541
Fax
(505) 445-4904
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP54278 NM Primary

Addresses

Primary practice location

4801 McMahon Blvd NW Ste 245
Albuquerque, NM 87114-5478

Mailing address

PO Box 44308
Rio Rancho, NM 87174-4308
Phone (505) 315-3541

Other identifiers 3

IdentifierTypeStateIssuer
RN81953OtherNMRN LICENSE
CS00226579OtherNMNM CONTROLLED SUBSTANCE
CNP54278OtherNMCNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190130001479 NM Practitioner - Nurse Practitioner 9830436773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Merit Family MedicineGroup PAC ID 3971839416, 2 clinicians

Practice addresses (Care Compare)

4801 McMahon Blvd NW
Suite 245
Albuquerque, NM 87114-5478
Phone (505) 315-3541

Hospital & facility affiliations

  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP54278NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Family Medicine CurrentSince Jun 15, 2019 Accepting new patients

Locations

4801 McMahon Blvd NW
Ste 245
Albuquerque, NM 87114
Phone (505) 315-3541

4020 Peggy Rd SE
Ste D
Rio Rancho, NM 87124
Phone (505) 896-2242

4101 Barbara Loop SE
Ste C
Rio Rancho, NM 87124
Phone (505) 315-3541

Interoperability endpoints

  • Direct secure messaging: meritfamilymedicine.brandyheaton@142729.advancedmd-direct.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1346719291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44308",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871744308",
            "telephone_number": "505-315-3541",
            "fax_number": "505-445-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MCMAHON BLVD NW STE 245",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145478",
            "telephone_number": "505-315-3541",
            "fax_number": "505-445-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "BRANDY",
        "middle_name": "DAWN",
        "credential": "FNP-C APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP54278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN81953",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM CONTROLLED SUBSTANCE",
            "identifier": "CS00226579",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNP LICENSE",
            "identifier": "CNP54278",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.