Individual provider Active NPI

Amy Heim, PHD

  • Clinical Psychologist
  • Tinley Park, IL
National Provider Identifier
1386629137
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Phone
(708) 429-6999
Fax
(708) 429-6909
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509

Mailing address

16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Phone (708) 429-6999

Other names 1

  • Amy Kegley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000896 MA Practitioner - Clinical Psychologist 0749277010 Practice locations: Lexington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9 Meriam St
Suite 25
Lexington, MA 02420-5312
Phone (617) 633-3740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8916MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlin C Hoover PHD PC Clinical 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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1386629137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-429-6999",
            "fax_number": "708-429-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-429-6999",
            "fax_number": "708-429-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KEGLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.