Individual provider Active NPI

John Eugene Heintzelman

  • Case Manager/Care Coordinator
  • Las Vegas, NV
National Provider Identifier
1639664543
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
777 N Rainbow Blvd Ste 360
Las Vegas, NV 89107-1188
Phone
(702) 947-4474
Fax
(702) 978-6215
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NV Primary

Addresses

Primary practice location

777 N Rainbow Blvd Ste 360
Las Vegas, NV 89107-1188

Mailing address

777 N Rainbow Blvd Ste 360
Las Vegas, NV 89107-1188
Phone (702) 947-4474

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

Practice roles

OrganizationSpecialtyStatusNew patients
United States Veterans Initiative - Las Vegas Case Manager/Care Coordinator PastSince Jul 17, 2018 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1639664543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAINBOW BLVD STE 360",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071188",
            "telephone_number": "702-947-4474",
            "fax_number": "702-978-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N RAINBOW BLVD STE 360",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071188",
            "telephone_number": "702-947-4474",
            "fax_number": "702-978-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZELMAN",
        "first_name": "JOHN",
        "middle_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.