NPIMap

Organization Active NPI

Heinen Medical Clinics LLC

Doing business as Heinen Medical Ville Platte

  • Rural Health Clinic/Center
  • Ville Platte, LA
National Provider Identifier
1871073304
Registry record updated Oct 6, 2020
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 Ville Platte
Practice address
825 W Lasalle St
Ville Platte, LA 70586
Phone
(337) 363-5521
Fax
(337) 363-9134
NPI assigned
Aug 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Jade N. Heinen, MD
Title
Ceo
Phone
(337) 457-8166

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

825 W Lasalle St
Ville Platte, LA 70586

Mailing address

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

Other names 1

  • Heinen Medical Ville Platte Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190522001918 LA Part A Provider - Rural Health Clinic 9739422304 Practice locations: Ville Platte, LA
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

Rural health clinic certification: CCN 193962

Legal name
HEINEN MEDICAL CLINICS LLC
Doing business as
HEINEN MEDICAL VILLE PLATTE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 22, 2020
Last certification
Apr 22, 2023
Ownership / control type
1C
Organization structure
LLCProprietary
Incorporated
Aug 29, 2018 in LA
Enrollment address
825 W Lasalle St
Ville Platte, LA 70586-3129

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.

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.

Locations

1210 E McNeese St
Lake Charles, LA 70607
Phone (337) 502-5303

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%
Corporate OfficerCeo Aug 29, 2018 50%
Corporate Director Aug 29, 2019 100%
Operational/Managerial ControlCeo Aug 29, 2018 50%
Brian N Heinen Individual 5% Or Greater Direct Ownership InterestPresident Aug 29, 2018 50%
Corporate OfficerPresident 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, Corporate Officer, Operational/Managerial Control

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

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1871073304",
    "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": "825 W LASALLE ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "70586",
            "telephone_number": "337-363-5521",
            "fax_number": "337-363-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEINEN MEDICAL CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "HEINEN",
        "authorized_official_first_name": "JADE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-457-8166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heinen Medical Ville Platte",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heinen Medical Ville Platte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.