Individual provider Active NPI

Nathalie Heimeyer

  • Dentist
  • Lake Jackson, TX
National Provider Identifier
1932939576
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40897 Issued in TX
Practice address
90 Oak Dr Ste C
Lake Jackson, TX 77566-5278
Phone
(979) 583-6005
NPI assigned
Aug 7, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40897 TX Primary

Addresses

Primary practice location

90 Oak Dr Ste C
Lake Jackson, TX 77566-5278

Mailing address

9631 Carson LN
Iowa Colony, TX 77583-1529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815000499 TX Order and Referring Only - DentistPractitioner - Dentist 8426557604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1932939576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 CARSON LN",
            "city": "IOWA COLONY",
            "state": "TX",
            "postal_code": "775831529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 OAK DR STE C",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665278",
            "telephone_number": "979-583-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMEYER",
        "first_name": "NATHALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.