Individual provider Active NPI

Holly L Heichelbech, D.O.

  • Family Medicine Physician
  • Oakland City, IN
National Provider Identifier
1538204367
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02003241A Issued in IN
Practice address
1204 Williams St
Oakland City, IN 47660-1001
Phone
(812) 749-6187
Fax
(812) 749-4966
NPI assigned
Feb 20, 2007
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02003241A IN Primary

Addresses

Primary practice location

1204 Williams St
Oakland City, IN 47660-1001

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 749-6187

Other identifiers 1

IdentifierTypeStateIssuer
200885450MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080214000344 IN Practitioner - Family Practice 9436232451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02003241AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Family Medicine CurrentSince Mar 1, 2011 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic Inc. Family Medicine CurrentSince Mar 1, 2011 Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: hheichelbech1744@direct.deaconess.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1538204367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-749-6187",
            "fax_number": "812-749-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 WILLIAMS ST",
            "city": "OAKLAND CITY",
            "state": "IN",
            "postal_code": "476601001",
            "telephone_number": "812-749-6187",
            "fax_number": "812-749-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEICHELBECH",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003241A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200885450",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland City, IN

Sources for this page

Verify at the official NPI Registry.