Individual provider Active NPI

Anne C Heenan, FNP

  • Family Nurse Practitioner
  • Newport, OR
National Provider Identifier
1356327605
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200050019NP Issued in OR
Practice address
1010 SW Coast Hwy Ste 203
Newport, OR 97365-5215
Phone
(541) 265-4947
Fax
(541) 574-7670
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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 200050019NP OR Primary

Addresses

Primary practice location

1010 SW Coast Hwy Ste 203
Newport, OR 97365-5215

Mailing address

1010 SW Coast Hwy Ste 203
Newport, OR 97365-5215
Phone (541) 265-4947

Other practice location 1

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (503) 571-1000

Other practice location 2

4422 NE Devils Lake Blvd Ste 2
Lincoln City, OR 97367-5000
Phone (541) 265-4947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040225001215 OR Practitioner - Nurse Practitioner 3779479738 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Physicians, LLC Family CurrentSince Oct 1, 2023 Accepting new patients
Integrity Women'S Health & Wellness, LLC Family Past Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

Interoperability endpoints

  • Direct secure messaging: aheenan631809@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1356327605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 203",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655215",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 203",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655215",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10180 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970158970",
            "country_code": "US",
            "telephone_number": "503-571-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4422 NE Devils Lake Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973675000",
            "country_code": "US",
            "telephone_number": "541-265-4947",
            "fax_number": "541-994-0261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEENAN",
        "first_name": "ANNE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200050019NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.