Katherine L Heineman, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

4455 Issued in IA

Practice address

3200 Grand Ave
Des Moines, IA 50312-4104

Phone

(515) 271-1732

Fax

(515) 271-1697

NPI assigned

Aug 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2021 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1780817809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1732",
            "fax_number": "515-271-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1732",
            "fax_number": "515-271-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINEMAN",
        "first_name": "KATHERINE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101018236",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101018236",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IA",
            "license": "4455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17808178909",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Brynn Hefner, DO
• Judith Heggen, DO
• Melissa Heidesch
• Bruce Charles Heilman, DDS
• John Thomas Heineman, MD, MPH
• Amy Heinrich, PHARMD
• Alyssa Nicole Heinzman, MD
• Megan Lynn Heise
• Marisa Ann Heisterkamp, DDS
• Tillie Heithoff

• All providers in Des Moines, IA
• Neuromusculoskeletal Medicine & OMM Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.