Jonathan Keith Heeren, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

ME 726 Issued in ME

Practice address

489 State St
Bangor, ME 04401-6616

Phone

(207) 973-7556

Fax

(207) 973-7674

NPI assigned

Jul 4, 2006

Last updated

Nov 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Virginia School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bucksport Regional Health CenterGroup PAC ID 9638135858, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Bucksport Regional Health Center

  • Federally Qualified Health Center (FQHC)
  • Bucksport, ME
  • NPI 1043271133
  Medicare reassignment Care Compare group NPD
• Bucksport Regional Health Center

  dba BRHC Coastal Pharmacy

  • Community/Retail Pharmacy
  • Bucksport, ME
  • NPI 1194561837
  NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1598795734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BROADWAY",
            "city": "BUCKSPORT",
            "state": "ME",
            "postal_code": "044164612",
            "telephone_number": "207-469-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7556",
            "fax_number": "207-973-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEREN",
        "first_name": "JONATHAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "ME 726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Heanssler, FNP
• Heartleaf ABA LLC
• Todd E Heaton, M.D.
• Deidre Heber, D.O.
• Julia Natalie Hedge
• Anna F Henderson, M.D.
• Mark Henderson, MD
• Beverly Henion
• Michelle D Henneberry, PMHNP
• Brandon Herbert, LMSW-CC

• Psychologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.