Individual provider Active NPI

Jessica Heffelfinger

  • Counselor
  • Moraine, OH
National Provider Identifier
1508400516
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.1902003-TRNE Issued in OH
Practice address
2211 Arbor Blvd
Moraine, OH 45439-1521
Phone
(937) 222-9481
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.1902003-TRNE OH Primary

Addresses

Primary practice location

2211 Arbor Blvd
Moraine, OH 45439-1521

Mailing address

2450 Antler CT
Fairborn, OH 45324-9219
Phone (910) 528-9763

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
C.1902003-TRNEOHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Association CurrentSince Nov 17, 2019 Accepting new patients

Locations

2211 Arbor Blvd
Moraine, OH 45439
Phone (937) 222-9481

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/fsadayton/r4/

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": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1508400516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 ANTLER CT",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453249219",
            "telephone_number": "910-528-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 ARBOR BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391521",
            "telephone_number": "937-222-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFELFINGER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1902003-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.