Individual provider Active NPI

Jessica C. Heim

  • Neonatal Nurse Practitioner
  • Austin, TX
National Provider Identifier
1477151413
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1020300 Issued in TX
Practice address
12221 N Mopac Expy
Austin, TX 78758-2401
Phone
(512) 901-1000
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 749243 TX
Neonatal Nurse Practitioner 363LN0000X 1020300 TX Primary

Addresses

Primary practice location

12221 N Mopac Expy
Austin, TX 78758-2401

Mailing address

21243 Rezanof Rd
Humble, TX 77338-1350

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
749243TXMDNeonatal Intensive Care Registered Nurse
1020300TXMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Past 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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1477151413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21243 REZANOF RD",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773381350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM",
        "first_name": "JESSICA",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "TX",
            "license": "749243",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "1020300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.