Dr Richard Heise LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DR RICHARD HEISE LLC

Practice address

111 W Port PLZ Ste 600
Saint Louis, MO 63146-3015

Phone

(314) 399-9707

Fax

(314) 474-0119

NPI assigned

Feb 4, 2020

Organization subpart

No

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

Authorized official

Name

Richard Allen HeiseNPI 1396773065

Title

PHD

Phone

(636) 730-0596

Specialties & licenses 1

Addresses

Other names 1

• Dr Richard Heise LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard A. Heise, PHD

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1396773065

  Clinical, MO

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1629600085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W PORT PLZ STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463015",
            "telephone_number": "314-399-9707",
            "fax_number": "314-474-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W PORT PLZ STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463015",
            "telephone_number": "314-399-9707",
            "fax_number": "314-474-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RICHARD HEISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2023-09-06",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "HEISE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PHD",
        "authorized_official_telephone_number": "636-730-0596"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Richard Heise LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Saint Louis, MO
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.