Individual provider Active NPI

Joseph Heron

  • Certified Registered Nurse Anesthetist
  • Waterbury, CT
National Provider Identifier
1700955499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
003492 Issued in CT
Practice address
140 Grandview Ave
Waterbury, CT 06708-2505
Phone
(203) 757-7000
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 003492 CT Primary

Addresses

Primary practice location

140 Grandview Ave
Waterbury, CT 06708-2505

Mailing address

39 Kelley St
Bristol, CT 06010-5704

Other identifiers 1

IdentifierTypeStateIssuer
079840OtherCTLICENSE NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110425000804 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133101140 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brazos Gi Anesthesia, LLCGroup PAC ID 7113197161, 5 clinicians

Practice addresses (Care Compare)

364 Richland W Cir
Waco, TX 76712-7919
Phone (254) 537-9250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
003492CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Gi Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Southern New England Anesthesia and Pain Associates, Inc Past Accepting new patients
Anesthesia Associates of Kent County, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
New England Anesthesiologists, Inc. Past Accepting new patients
Waterbury Anesthesiology Assoc. Inc Past Accepting new patients
Jordan Hospital Anesthesia Associates, PC Past Accepting new patients

Locations

8015 Shoal Creek Blvd
Ste 118
Austin, TX 78757
Phone (512) 485-5890

8015 Shoal Creek Blvd
Ste 300
Austin, TX 78757
Phone (512) 371-1519

4310 James Casey St
Ste 4B
Austin, TX 78745
Phone (512) 407-8444

8015 Shoal Creek Blvd
Austin, TX 78757
Phone (512) 971-1519

3030 S Gessner Rd
Ste 150
Houston, TX 77063
Phone (713) 587-0909

8550 Datapoint Dr
Ste 100
San Antonio, TX 78229
Phone (210) 615-7232

364 Richland West Cir
Waco, TX 76712
Phone (254) 537-0306

Organizations & group practices 7

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700955499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 KELLEY ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082505",
            "telephone_number": "203-757-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERON",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "003492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "079840",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.