Individual provider Active NPI

Jimmie Lee Heags Jr.

  • Professional Counselor
  • Brooklyn Center, MN
National Provider Identifier
1497253512
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
858 Issued in MN
Practice address
5901 Brooklyn Blvd Ste 205
Brooklyn Center, MN 55429-2533
Phone
(612) 440-0914
NPI assigned
Jan 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 858 MN Primary

Addresses

Primary practice location

5901 Brooklyn Blvd Ste 205
Brooklyn Center, MN 55429-2533

Mailing address

5901 Brooklyn Blvd Ste 205
Brooklyn Center, MN 55429-2533
Phone (612) 440-0914

Other names 1

  • Mr. Jimmie Lee Heags Jr. Professional name

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

LicenseStateTypeSpecialty
858MNMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1497253512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 BROOKLYN BLVD STE 205",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554292533",
            "telephone_number": "612-440-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROOKLYN BLVD STE 205",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554292533",
            "telephone_number": "612-440-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAGS",
        "first_name": "JIMMIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIMMIE",
            "last_name": "HEAGS",
            "middle_name": "LEE",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "LPCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.