Active NPI
Jonathan W Hiemer, D.M.D.
- Dentist
- Louisville, KY
National Provider Identifier
1487647863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6188
- Practice address
- 6604 Bardstown Rd
Suite: B
Louisville, KY 40291-3045 - Phone
- (502) 239-6850
- Fax
- (502) 239-3425
- NPI assigned
- Aug 31, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6188 | KY | Primary |
| General Practice Dentistry | 1223G0001X | 6188 | KY |
Addresses
Primary practice location
6604 Bardstown Rd
Suite: B
Louisville, KY 40291-3045
Mailing address
6604 Bardstown Rd
Suite: B
Louisville, KY 40291-3045
Phone (502) 239-6850
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y292 | Other | KY | BCBS PROVIDER NUMBER |
| 60061884 | Medicaid | KY | |
| 469970 | Other | KY | UNITED CONCORDIA |
| 6342 | Other | KY | PASSPORT PROVIDER NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6188 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1487647863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6604 BARDSTOWN RD",
"address_2": "SUITE: B",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402913045",
"telephone_number": "502-239-6850",
"fax_number": "502-239-3425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6604 BARDSTOWN RD",
"address_2": "SUITE: B",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402913045",
"telephone_number": "502-239-6850",
"fax_number": "502-239-3425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIEMER",
"first_name": "JONATHAN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "6188",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "6188",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "Y292",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60061884",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "469970",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT PROVIDER NUMBER",
"identifier": "6342",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.