NPIMap

Individual provider Active NPI

Will D Heise, MD

  • Family Medicine Physician
  • Choctaw, OK
National Provider Identifier
1962840504
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32026 Issued in OK
Practice address
15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone
(405) 390-1800
Fax
(405) 390-3846
NPI assigned
Jun 5, 2013
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10046113 TX
Family Medicine Physician 207Q00000X 32026 OK Primary

Addresses

Primary practice location

15679 NE 23Rd St
Choctaw, OK 73020-8592

Mailing address

15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone (405) 390-1800

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wheise176612@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803000127 OK Practitioner - Family Practice 7517265028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

6201 N Santa Fe
Suite 2010
Oklahoma City, OK 73118-7538
Phone (405) 272-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Saints Medical Group, LLC Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
SSM Health Care of Oklahoma, Inc. Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Saints Medical Group, LLC CurrentSince Apr 1, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

15679 NE 23rd St
Choctaw, OK 73020
Phone (405) 390-1800

18961 NE 23rd St
Harrah, OK 73045
Phone (405) 390-1800

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

6201 N Santa Fe Ave
Ste 2010
Oklahoma City, OK 73118
Phone (405) 272-5555

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Interoperability endpoints

  • Direct secure messaging: wheise176612@direct-ehr-ssmhc.com

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1962840504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15679 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208592",
            "telephone_number": "405-390-1800",
            "fax_number": "405-390-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15679 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208592",
            "telephone_number": "405-390-1800",
            "fax_number": "405-390-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISE",
        "first_name": "WILL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10046113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "32026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wheise176612@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wheise176612@direct-ehr-ssmhc.com",
            "address_1": "15679 NE 23rd St",
            "city": "Choctaw",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730208592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "15679 NE 23rd St",
            "city": "Choctaw",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730208592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Choctaw, OK

Sources for this page

Verify at the official NPI Registry.