Active NPI
John Harrison Heiligenstein, M.D.
- Neurodevelopmental Disabilities Physician
- Indianapolis, IN
National Provider Identifier
1962763227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurodevelopmental Disabilities Physician
- License
- 01043276A
- Practice address
- 4470 Braedonwood
Indianapolis, IN 46228-3367 - Phone
- (317) 225-1449
- NPI assigned
- Jun 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 01043276A | IN | |
| Neurodevelopmental Disabilities Physician | 2084P0005X | 01043276A | IN | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 01043276A | IN |
Addresses
Primary practice location
4470 Braedonwood
Indianapolis, IN 46228-3367
Mailing address
4470 Braedonwood
Indianapolis, IN 46228-3367
Phone (317) 225-1449
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01043276A | IN | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338768000000",
"number": "1962763227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4470 BRAEDONWOOD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462283367",
"telephone_number": "317-225-1449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4470 BRAEDONWOOD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462283367",
"telephone_number": "317-225-1449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEILIGENSTEIN",
"first_name": "JOHN",
"middle_name": "HARRISON",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-04",
"last_updated": "2012-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "IN",
"license": "01043276A",
"primary": false
},
{
"code": "2084P0005X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
"state": "IN",
"license": "01043276A",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IN",
"license": "01043276A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.