NPIMap

Individual provider Active NPI

Jordan Dean Heins, PA-C

  • Physician Assistant
  • Rapid City, SD
National Provider Identifier
1407365901
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1116 Issued in SD
Practice address
2805 5TH St
Rapid City, SD 57701-6003
Phone
(605) 755-5700
NPI assigned
Sep 27, 2017
Last updated
Sep 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1116 SD Primary

Addresses

Primary practice location

2805 5TH St
Rapid City, SD 57701-6003

Mailing address

1260 Ziebach St
Rapid City, SD 57703-0172
Phone (620) 344-1538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171120002726 SD Practitioner - Physician Assistant 4385901727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2805 5TH St
Rapid City, SD 57701-6003
Phone (605) 755-5700

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1116SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Oct 13, 2017 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Oct 13, 2017 Accepting new patients
West River Dermatology, PC Past Accepting new patients

Locations

2805 5th St
Rapid City, SD 57701
Phone (605) 719-5650

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

677 Cathedral Dr
Ste 310
Rapid City, SD 57701
Phone (605) 755-6720

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1407365901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 ZIEBACH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577030172",
            "telephone_number": "620-344-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016003",
            "telephone_number": "605-755-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINS",
        "first_name": "JORDAN",
        "middle_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.