Individual provider Active NPI

Jay Andrew Heaverlo, DACM

  • Acupuncturist
  • Urbandale, IA
National Provider Identifier
1386311538
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
A49 Issued in IA
Practice address
2687 100TH St
Urbandale, IA 50322-3808
Phone
(515) 554-6728
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A49 IA Primary

Addresses

Primary practice location

2687 100TH St
Urbandale, IA 50322-3808

Mailing address

2687 100TH St
Urbandale, IA 50322-3808
Phone (515) 554-6728

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

LicenseStateTypeSpecialty
A49IAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1386311538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 100TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223808",
            "telephone_number": "515-554-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 100TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223808",
            "telephone_number": "515-554-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVERLO",
        "first_name": "JAY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DACM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IA",
            "license": "A49",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.