Active NPI
Richard W Heinl, PA
- Physician Assistant
- Cleveland, TN
National Provider Identifier
1821030891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 884
- Practice address
- 2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746 - Phone
- (423) 479-9679
- Fax
- (423) 559-9046
- NPI assigned
- Jun 12, 2006
- Last updated
- Dec 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 884 | TN | Primary |
Addresses
Primary practice location
2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746
Mailing address
2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 884 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Past | Accepting new patients | |
| The Nemours Foundation | Past | Accepting new patients | |
| Physician Services of Cleveland, PC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Cleveland, TN
- NPI 1457378341
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1821030891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 EXECUTIVE PARK NW",
"address_2": "SUITE 5",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373122746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 EXECUTIVE PARK NW",
"address_2": "SUITE 5",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373122746",
"telephone_number": "423-479-9679",
"fax_number": "423-559-9046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINL",
"first_name": "RICHARD",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.