Active NPI
Dylan Heemstra
- Marriage & Family Therapist
- Fitchburg, WI
National Provider Identifier
1982483574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 2861 Rimrock Rd
Fitchburg, WI 53713-3338 - Phone
- (920) 224-3492
- NPI assigned
- Sep 25, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
2861 Rimrock Rd
Fitchburg, WI 53713-3338
Mailing address
2861 Rimrock Rd
Fitchburg, WI 53713-3338
Phone (920) 224-3492
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1982483574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2861 RIMROCK RD",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537133338",
"telephone_number": "920-224-3492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2861 RIMROCK RD",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537133338",
"telephone_number": "920-224-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEEMSTRA",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.