NPIMap

Organization Active NPI

Heinen Medical Clinics LLC

Doing business as Heinen Medical Kinder

  • Rural Health Clinic/Center
  • Kinder, LA
National Provider Identifier
1841928660
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HEINEN MEDICAL CLINICS LLC
Doing business as
Heinen Medical Kinder
Practice address
325 North 8TH Street
Kinder, LA 70648
Phone
(337) 998-8151
Fax
(887) 671-1263
NPI assigned
Aug 10, 2022
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Jade Nicholas Heinen, MDNPI 1174732424
Title
Ceo
Phone
(337) 457-8166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

325 North 8TH Street
Kinder, LA 70648

Mailing address

151 Leon Ave Ste B
Eunice, LA 70535-3938
Phone (337) 457-8166

Other names 1

  • Heinen Medical Kinder Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210924001137 LA Part B Supplier - Clinic/Group Practice 9739422304 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eunice, LA; Kinder, LA; Ville Platte, LA
O20231006000956 LA Part A Provider - Rural Health Clinic 9739422304 Practice locations: Kinder, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841928660. Details of each certification follow.

Rural health clinic certification: CCN 198918

Legal name
HEINEN MEDICAL CLINICS LLC
Doing business as
HEINEN MEDICAL KINDER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 13, 2023
Last certification
Jul 13, 2023
Ownership / control type
1C
Organization structure
LLCProprietary
Incorporated
Aug 29, 2018 in LA
Enrollment address
325 N 8TH St
Kinder, LA 70648-3438

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2273037Heinen Medical Kinder325 North 8TH Street, Kinder, LA 70648Certificate of waiverDec 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Heinen Medical Clinics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jade N Heinen Individual 5% Or Greater Direct Ownership InterestCeo Aug 29, 2018 50%
General Partnership InterestCeo Aug 29, 2018 50%
Operational/Managerial ControlCeo Aug 29, 2018 50%
Brian N Heinen Individual 5% Or Greater Direct Ownership InterestPresident Aug 29, 2018 50%
General Partnership InterestPresident Aug 29, 2018 50%
Operational/Managerial ControlPresident Aug 29, 2018 50%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Brian N. Heinen, M.D.
    • Family Medicine Physician
    • Eunice, LA
    • NPI 1457362899

    5% Or Greater Direct Ownership Interest, General Partnership Interest, Operational/Managerial Control

    CMS ownership
  • Jade Nicholas Heinen, M.D.
    • Family Medicine Physician
    • Eunice, LA
    • NPI 1174732424

    5% Or Greater Direct Ownership Interest, General Partnership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1841928660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 LEON AVE STE B",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353938",
            "telephone_number": "337-457-8166",
            "fax_number": "888-371-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NORTH 8TH STREET",
            "city": "KINDER",
            "state": "LA",
            "postal_code": "70648",
            "telephone_number": "337-998-8151",
            "fax_number": "887-671-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEINEN MEDICAL CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "HEINEN",
        "authorized_official_first_name": "JADE",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-457-8166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heinen Medical Kinder",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kinder, LA

Sources for this page

Verify at the official NPI Registry.