Individual provider Active NPI

Amanda Nichole Heusinger, D.M.D.

  • General Practice Dentistry
  • Madison, AL
National Provider Identifier
1801110796
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5654 Issued in AL
Practice address
8263 Madison Boulevaurd
Suite a
Madison, AL 35758
Phone
(256) 774-7228
Fax
(256) 774-2774
NPI assigned
Mar 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5654 AL Primary
Prosthodontics 1223P0700X 5654 AL

Addresses

Primary practice location

8263 Madison Boulevaurd
Suite a
Madison, AL 35758

Mailing address

8263 Madison Boulevaurd
Suite a
Madison, AL 35758
Phone (256) 774-7228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160205001065 AL Order and Referring Only - Other (Non-Physician) 0042514499
I20170825001870 AL Order and Referring Only - DentistPractitioner - Dentist 0042514499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5654ALMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1269129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1801110796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8263 MADISON BOULEVAURD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-774-7228",
            "fax_number": "256-774-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8263 MADISON BOULEVAURD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-774-7228",
            "fax_number": "256-774-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEUSINGER",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-21",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5654",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "AL",
            "license": "5654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.