Courtney Rae Heine, RD, LD, CMHIMP

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2014012347 Issued in MO

Practice address

884 Acid Mine Rd
Sullivan, MO 63080-2695

Phone

(573) 619-5188

NPI assigned

Feb 26, 2019

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Courtney Rae Humphrey Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 26, 2019.

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1407313406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 ACID MINE RD",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 ACID MINE RD",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802695",
            "telephone_number": "573-619-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINE",
        "first_name": "COURTNEY",
        "middle_name": "RAE",
        "credential": "RD, LD, CMHIMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2014012347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "HUMPHREY",
            "middle_name": "RAE",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca M Hankins-Farber, FNP
• Craig Harris, DDS
• Michelle A Hassard, APRN FNP
• Raysham Hayat, DDS
• Brittney Renee Haymer, LCSW
• Nicole Herbel, NP
• Kirsten Heyer, M.A.
• Hill Chiropractic P.C.
• William L Hill, D.C.
• Patricia Hinkle, M.D.

• All providers in Sullivan, MO
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.