Active NPI
Jacques J Heibig, M.D.
- Cardiovascular Disease Physician
- Columbia, TN
National Provider Identifier
1487717955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 28471
- Practice address
- 1220 Trotwood Ave
Suite 401
Columbia, TN 38401-6433 - Phone
- (931) 388-8622
- Fax
- (931) 388-8227
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 28471 | TN | Primary |
Addresses
Primary practice location
1220 Trotwood Ave
Suite 401
Columbia, TN 38401-6433
Mailing address
854 W James Campbell Blvd
Suite 303a
Columbia, TN 38401-4659
Phone (931) 540-4255
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4041153 | Other | TN | BCBS TN |
| 3804533 | Medicaid | TN | |
| 3379860 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28471 | TN | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Madison County General Hospital | Past | Accepting new patients | |
| Middle Tennessee Urology Associates PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Jackson, TN
- NPI 1467493916
-
- Urology Physician
- Columbia, TN
- NPI 1700837341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1487717955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "854 W JAMES CAMPBELL BLVD",
"address_2": "SUITE 303A",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384014659",
"telephone_number": "931-540-4255",
"fax_number": "931-490-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 TROTWOOD AVE",
"address_2": "SUITE 401",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384016433",
"telephone_number": "931-388-8622",
"fax_number": "931-388-8227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIBIG",
"first_name": "JACQUES",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "28471",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN",
"identifier": "4041153",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3804533",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3379860",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.