Active NPI
Maryjo Leigh Heise, APNP
- Family Nurse Practitioner
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5010-33
- Practice address
- 720 S Vanburen St
Suite201
Green Bay, WI 54301-3534 - Phone
- (920) 433-7488
- Fax
- (920) 433-7439
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 135351-030 | WI | |
| Family Nurse Practitioner | 363LF0000X | 5010-33 | WI | Primary |
Addresses
Primary practice location
720 S Vanburen St
Suite201
Green Bay, WI 54301-3534
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other practice location 2
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F0812139 | Other | AMERICAN ACADEMY OF NURSE PRACTITIONERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oconto Hospital and Medical Center Inc
Practice addresses (Care Compare)
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534
Phone (920) 433-7488
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135351-030 | WI | MD | Registered Nurse |
| 5010 | WI | MD | Occupational Therapist |
| 5010-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Past | Accepting new patients | |
| Bellin Memorial Hospital Inc | Past | Accepting new patients |
Locations
933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
720 S Van Buren St
Ste 201
Green Bay, WI 54301
Phone (920) 430-7100
2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
855 S Main St
Oconto Falls, WI 54154
Phone (920) 846-3444
Interoperability endpoints
- mheise32897@direct.thedacare.org
- mheise927068@direct.emplifyhealth.org
Organizations & group practices 9
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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Emplify Health Oconto Hospital
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
dba Bellin Health Marinette Surgery Center
- Ambulatory Surgical Clinic/Center
- Marinette, WI
- NPI 1881129351
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
dba FMC Sturgeon Bay
- Family Medicine Physician
- Sturgeon Bay, WI
- NPI 1063893352
-
dba Bellin Health Suring
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
dba Bellin Health Peshtigo
- Rural Health Clinic/Center
- Peshtigo, WI
- NPI 1649628249
-
dba Bellin Health Surgical Associates
- Surgery Physician
- Green Bay, WI
- NPI 1104263532
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1689790461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S VANBUREN ST",
"address_2": "SUITE201",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013534",
"telephone_number": "920-433-7488",
"fax_number": "920-433-7439"
}
],
"practiceLocations": [
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "541532004",
"country_code": "US",
"telephone_number": "920-835-1100",
"fax_number": "920-835-1099",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2820 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Marinette",
"state": "WI",
"postal_code": "541433834",
"country_code": "US",
"telephone_number": "715-735-5225",
"fax_number": "715-735-5388",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEISE",
"first_name": "MARYJO",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "135351-030",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "5010-33",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
"identifier": "F0812139",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.