Individual provider Active NPI

John Edward Heindl, DO

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1790766194
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2090 Issued in OH
Practice address
4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4500
Phone
(513) 752-8000
Fax
(513) 752-1078
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2090 OH Primary

Addresses

Primary practice location

4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4500

Mailing address

4421 Eastgate Blvd
Suite 300
Cincinnati, OH 45245-4500
Phone (513) 752-8000

Other identifiers 1

IdentifierTypeStateIssuer
0196961MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2090OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati, LLC Family Medicine CurrentSince Apr 2, 2008 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Apr 2, 2008 Accepting new patients

Locations

4421 Eastgate Blvd
Ste 300
Cincinnati, OH 45245
Phone (513) 752-8000

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1790766194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 EASTGATE BLVD",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452454500",
            "telephone_number": "513-752-8000",
            "fax_number": "513-752-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 EASTGATE BLVD",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452454500",
            "telephone_number": "513-752-8000",
            "fax_number": "513-752-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINDL",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "2090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0196961",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.