Individual provider Active NPI

Andre T Heard

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
National Provider Identifier
1750660254
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
K080938444 Issued in OK
Practice address
7021 Briarcreek Dr
Oklahoma City, OK 73162-7232
Phone
(405) 886-2365
NPI assigned
Aug 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X K080938444 OK Primary

Addresses

Primary practice location

7021 Briarcreek Dr
Oklahoma City, OK 73162-7232

Mailing address

7021 Briarcreek Dr
Oklahoma City, OK 73162-7232
Phone (405) 886-2365

Other identifiers 1

IdentifierTypeStateIssuer
K080938444MedicaidOK

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

State licenses

LicenseStateTypeSpecialty
K080938444OKMDCommunity/Behavioral Health Agency

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1750660254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7021 BRIARCREEK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731627232",
            "telephone_number": "405-886-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 BRIARCREEK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731627232",
            "telephone_number": "405-886-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "ANDRE",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "K080938444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K080938444",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.