Active NPI
Kenneth S Heinen, DC
- Chiropractor
- Sheboygan, WI
National Provider Identifier
1417094368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3643-012
- Practice address
- 1539 33Rd Place
Suite B
Sheboygan, WI 53081-1826 - Phone
- (920) 451-9960
- Fax
- (920) 451-9965
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3643-012 | WI | Primary |
Addresses
Primary practice location
1539 33Rd Place
Suite B
Sheboygan, WI 53081-1826
Mailing address
1539 33Rd Place
Suite B
Sheboygan, WI 53081-1826
Phone (920) 451-9960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38927500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1539 N 33Rd PL
Suite B
Sheboygan, WI 53081-1839
Phone (920) 451-9960
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3643-012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heinen Chiropractic, SC | Current | Accepting new patients | |
| Heinen Chiropractic, S.C. | Chiropractor | Current | Accepting new patients |
Locations
1539 N 33rd Pl
Ste B
Sheboygan, WI 53081
Phone (920) 451-9960
Organizations & group practices 2
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.
-
- Chiropractor
- Sheboygan, WI
- NPI 1295069433
-
- Clinic/Center
- Sheboygan, WI
- NPI 1518007756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1417094368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1539 33RD PLACE",
"address_2": "SUITE B",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811826",
"telephone_number": "920-451-9960",
"fax_number": "920-451-9965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1539 33RD PLACE",
"address_2": "SUITE B",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811826",
"telephone_number": "920-451-9960",
"fax_number": "920-451-9965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINEN",
"first_name": "KENNETH",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "3643-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38927500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.