Individual provider Active NPI

Jonathan F Heilman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1952872921
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0994505-NP Issued in CO
Practice address
4601 Corbett Dr
Fort Collins, CO 80528-9579
Phone
(970) 207-4857
Fax
(970) 207-4885
NPI assigned
Dec 16, 2018
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0994505-NP CO Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN.1643694 CO

Addresses

Primary practice location

4601 Corbett Dr
Fort Collins, CO 80528-9579

Mailing address

6505 Spring Valley Rd
Timnath, CO 80547-2529
Phone (617) 548-7177

Other practice location 1

4333 Corbett Dr # 1068
Fort Collins, CO 80525-6111
Phone (617) 548-7167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.1643694COMDPsychiatric/Mental Health Registered Nurse
APN.0994505-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care, Inc CurrentSince May 20, 2019 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Health Care Inc CurrentSince May 20, 2019 Accepting new patients

Locations

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

2315 E Harmony Rd
Ste 200
Fort Collins, CO 80528

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1952872921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 SPRING VALLEY RD",
            "city": "TIMNATH",
            "state": "CO",
            "postal_code": "805472529",
            "telephone_number": "617-548-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 CORBETT DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289579",
            "telephone_number": "970-207-4857",
            "fax_number": "970-207-4885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4333 Corbett Dr # 1068",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805256111",
            "country_code": "US",
            "telephone_number": "617-548-7167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "JONATHAN",
        "middle_name": "F",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-02-02",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0994505-NP",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CO",
            "license": "RN.1643694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.