Active NPI
Christopher Dabney Heffner, MD
- Neurological Surgery Physician
- Belleville, IL
National Provider Identifier
1740286335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 036084029
- Practice address
- 4700 Memorial Dr
Ste 200
Belleville, IL 62226-5373 - Phone
- (618) 222-9192
- Fax
- (618) 222-9234
- NPI assigned
- Jun 28, 2005
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 036084029 | IL | Primary |
Addresses
Primary practice location
4700 Memorial Dr
Ste 200
Belleville, IL 62226-5373
Mailing address
4700 Memorial Dr
Ste 200
Belleville, IL 62226-5373
Phone (618) 222-9192
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036084029 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036084029 | IL | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Msa Alliance, LLC | Neurological Surgery | Past | Accepting new patients |
| Christopher Heffner,M.D. of Illinois, P.C. | Neurological Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Neurological Surgery Physician
- Belleville, IL
- NPI 1295822450
Neurological Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1740286335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR",
"address_2": "STE 200",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-222-9192",
"fax_number": "618-222-9234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR",
"address_2": "STE 200",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-222-9192",
"fax_number": "618-222-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEFFNER",
"first_name": "CHRISTOPHER",
"middle_name": "DABNEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "IL",
"license": "036084029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036084029",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.