NPIMap

Individual provider Active NPI

Alison R Heffernan, M.D.

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1417978107
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.093625 Issued in OH
Practice address
10700 Montgomery Rd
Suite 100
Cincinnati, OH 45242-3255
Phone
(513) 984-5552
Fax
(513) 984-5552
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43664 TN
Pediatrics Physician 208000000X MD.026395 LA
Pediatrics Physician 208000000X 35.093625 OH Primary

Addresses

Primary practice location

10700 Montgomery Rd
Suite 100
Cincinnati, OH 45242-3255

Mailing address

10700 Montgomery Rd
Suite 100
Cincinnati, OH 45242-3255
Phone (513) 984-5552

Other identifiers 2

IdentifierTypeStateIssuer
03625756MedicaidMS
1062707MedicaidLA

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
MD.026395LAMDPediatrics Physician
35.093625OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Pediatrics Incorporated Past Accepting new patients
Centennial Pediatrics PC Pediatrics PastSince Oct 1, 2012 Accepting new patients
Children'S Hospital Medical Center Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alison.heffernan.1@8872.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8872/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1417978107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MONTGOMERY RD",
            "address_2": "SUITE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452423255",
            "telephone_number": "513-984-5552",
            "fax_number": "513-984-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MONTGOMERY RD",
            "address_2": "SUITE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452423255",
            "telephone_number": "513-984-5552",
            "fax_number": "513-984-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "ALISON",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "43664",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.026395",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.093625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03625756",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1062707",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.