Individual provider Active NPI

Thomas Edward Heering Jr., DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Wpafb, OH
National Provider Identifier
1609354505
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21579 Issued in TN
Practice address
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone
(937) 257-8718
NPI assigned
Aug 2, 2018
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 901410 MS
Certified Registered Nurse Anesthetist 367500000X 21579 TN Primary
Critical Care Medicine Registered Nurse 163WC0200X 161429 TN

Addresses

Primary practice location

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Mailing address

88 MDG/SGHJ
4881 Sugar Maple Dr
Wright-Patterson AFB, OH 45433

Other practice location 1

301 Fisher Street
Keesler Medical Center Department of Anesthesia
Biloxi, MS 39534
Phone (228) 376-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210121001089 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749694412 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
161429TNMDCritical Care Medicine Registered Nurse
21579TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services Network LTD CurrentSince Oct 5, 2022 Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1609354505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-8718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Fisher Street",
            "address_2": "Keesler Medical Center Department of Anesthesia",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "39534",
            "country_code": "US",
            "telephone_number": "228-376-6017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERING",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901410",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "21579",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "161429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wpafb, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.