Individual provider Active NPI

Kyle Heisey

  • Family Medicine Physician
  • Toppenish, WA
National Provider Identifier
1982790176
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00028899 Issued in WA
Practice address
510 W 1St Ave
Toppenish, WA 98948-1564
Phone
(509) 865-5600
Fax
(509) 865-5783
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00028899 WA Primary

Addresses

Primary practice location

510 W 1St Ave
Toppenish, WA 98948-1564

Mailing address

510 W 1St Ave
Toppenish, WA 98948-1564
Phone (509) 865-5600

Other identifiers 6

IdentifierTypeStateIssuer
63561OtherWAL & I
22899OtherGROUP HEALTH
8138935OtherWACHPW
8138935MedicaidWA
911019392OtherCOMMERCIAL
HE0007OtherWAREGENCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kheisey4843@yvfwc.direct-ci.com Direct

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00028899WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1982790176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 1ST AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481564",
            "telephone_number": "509-865-5600",
            "fax_number": "509-865-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 1ST AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481564",
            "telephone_number": "509-865-5600",
            "fax_number": "509-865-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEY",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00028899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "63561",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "22899",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHPW",
            "identifier": "8138935",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8138935",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "HE0007",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kheisey4843@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "510 W 1st Ave",
            "city": "Toppenish",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989481564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toppenish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.