Individual provider Active NPI

Megan Marie Heitzman, LMSW

  • Clinical Social Worker
  • Coralville, IA
National Provider Identifier
1811051501
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06081 Issued in IA
Practice address
1150 5TH St
Suite 155
Coralville, IA 52241-2932
Phone
(319) 338-2044
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 06081 IA Primary
Social Worker 104100000X 06081 IA

Addresses

Primary practice location

1150 5TH St
Suite 155
Coralville, IA 52241-2932

Mailing address

1150 5TH St
Suite 155
Coralville, IA 52241-2932
Phone (319) 338-2044

Other identifiers 2

IdentifierTypeStateIssuer
600593449OtherIAMAGELLAN BEHAVIORAL HEALTH
79141OtherIABLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
06081IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1811051501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 5TH ST",
            "address_2": "SUITE 155",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412932",
            "telephone_number": "319-338-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 5TH ST",
            "address_2": "SUITE 155",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412932",
            "telephone_number": "319-338-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06081",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALTH",
            "identifier": "600593449",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "79141",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.