Individual provider Active NPI

Devon Robert Heim

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Madison, WI
National Provider Identifier
1811487366
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
H500-1769-7047-07 Issued in WI
Practice address
2000 Observatory Dr
Madison, WI 53706-1121
Phone
(715) 505-3781
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X H500-1769-7047-07 WI Primary

Addresses

Primary practice location

2000 Observatory Dr
Madison, WI 53706-1121

Mailing address

E6257 821St Ave
Colfax, WI 54730-4406

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
H500-1769-7047-07WIMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1811487366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E6257 821ST AVE",
            "city": "COLFAX",
            "state": "WI",
            "postal_code": "547304406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OBSERVATORY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537061121",
            "telephone_number": "715-505-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM",
        "first_name": "DEVON",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WI",
            "license": "H500-1769-7047-07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.