Active NPI
Timothy P Heran, RDN, CGD, CD
- Gerontological Nutrition Registered Dietitian
- Port Orchard, WA
National Provider Identifier
1669015731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontological Nutrition Registered Dietitian
- License
- 843377
- Practice address
- 1141 Beach Dr E
Port Orchard, WA 98366-4937 - Phone
- (360) 895-4668
- NPI assigned
- Oct 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontological Nutrition Registered Dietitian | 133VN1101X | 843377 | Primary |
Addresses
Primary practice location
1141 Beach Dr E
Port Orchard, WA 98366-4937
Mailing address
1141 Beach Dr E
Port Orchard, WA 98366-4937
Phone (360) 895-4668
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DIII604031181 | Other | WA | CERTIFIED DIETITIAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | timothyh@dva.wa.gov | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1669015731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 BEACH DR E",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983664937",
"telephone_number": "360-895-4668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 BEACH DR E",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983664937",
"telephone_number": "360-895-4668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERAN",
"first_name": "TIMOTHY",
"middle_name": "P",
"credential": "RDN, CGD, CD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1101X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Gerontological",
"state": null,
"license": "843377",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED DIETITIAN",
"identifier": "DIII604031181",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "timothyh@dva.wa.gov",
"affiliation": "N",
"endpointDescription": "work email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1141 Beach Dr E",
"city": "Port Orchard",
"state": "WA",
"country_code": "US",
"postal_code": "983664937",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.