Individual provider Active NPI

Debbie Jane Hearn

  • Registered Dietitian
  • Harrisburg, IL
National Provider Identifier
1801436175
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.005485 Issued in IL
Practice address
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone
(618) 253-0462
Fax
(618) 253-7104
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.005485 IL Primary

Addresses

Primary practice location

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718

Mailing address

106 N Carlyle St # 12
Pittsburg, IL 62974-1034
Phone (618) 997-6309

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
164.005485ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1801436175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N CARLYLE ST # 12",
            "city": "PITTSBURG",
            "state": "IL",
            "postal_code": "629741034",
            "telephone_number": "618-997-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DR WARREN TUTTLE DR",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462718",
            "telephone_number": "618-253-0462",
            "fax_number": "618-253-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "DEBBIE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.