Individual provider Active NPI

David L Heard, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Edmonds, WA
National Provider Identifier
1386636934
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
00015414 Issued in WA
Practice address
21600 Hwy 99
Suite 255
Edmonds, WA 98026-8012
Phone
(425) 774-2628
Fax
(425) 774-2676
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 00015414 WA Primary

Addresses

Primary practice location

21600 Hwy 99
Suite 255
Edmonds, WA 98026-8012

Mailing address

21600 Hwy 99
Ste 255
Edmonds, WA 98026-8047
Phone (425) 774-2628

Other identifiers 2

IdentifierTypeStateIssuer
1922905MedicaidWA
18297OtherWAWORKER'S COMP

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00015414WAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Washington PLLC PastSince Oct 3, 2005 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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1386636934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HWY 99",
            "address_2": "STE 255",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268047",
            "telephone_number": "425-774-2628",
            "fax_number": "425-774-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HWY 99",
            "address_2": "SUITE 255",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-774-2628",
            "fax_number": "425-774-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "00015414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922905",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP",
            "identifier": "18297",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.