Individual provider Active NPI

Donald J. Heyburn, ATC

  • Specialist
  • Montville, NJ
National Provider Identifier
1518035112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MT00099700 Issued in NJ
Practice address
100 Horseneck Rd
Montville, NJ 07045-9626
Phone
(973) 331-7100
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MT00099700 NJ Primary

Addresses

Primary practice location

100 Horseneck Rd
Montville, NJ 07045-9626

Mailing address

222 Sailer St
Cranford, NJ 07016-2547
Phone (908) 272-1416

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
25MT00099700NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518035112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SAILER ST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162547",
            "telephone_number": "908-272-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HORSENECK RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459626",
            "telephone_number": "973-331-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYBURN",
        "first_name": "DONALD",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MT00099700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.