Individual provider Active NPI

Heather Inkman Kinder

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1720563539
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP137812 Issued in TX
Practice address
16619 Vicarage CT
Dallas, TX 75248-2227
Phone
(917) 592-0474
NPI assigned
Sep 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP137812 TX Primary

Addresses

Primary practice location

16619 Vicarage CT
Dallas, TX 75248-2227

Mailing address

16619 Vicarage CT
Dallas, TX 75248-2227
Phone (917) 592-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221116002613 TX Practitioner - Nurse Practitioner 7517335987 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kopec Functional Wellness, LLC Adult Health Current Accepting new patients
Heal 360 Primary Care PLLC CurrentSince Aug 14, 2022 Accepting new patients
Heal 360 Urgent Care, LLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

1360 Star Ct
Ste T1
Plano, TX 75074
Phone (972) 200-7402

4013 14th St
Ste 401
Plano, TX 75074
Phone (469) 814-9523

2806 W FM 544
Wylie, TX 75098

Organizations & group practices 3

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": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1720563539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16619 VICARAGE CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482227",
            "telephone_number": "917-592-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16619 VICARAGE CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482227",
            "telephone_number": "917-592-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDER",
        "first_name": "HEATHER",
        "middle_name": "INKMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP137812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.