Active NPI
Kyle Heisey
- Family Medicine Physician
- Toppenish, WA
National Provider Identifier
1982790176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00028899
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63561 | Other | WA | L & I |
| 22899 | Other | GROUP HEALTH | |
| 8138935 | Other | WA | CHPW |
| 8138935 | Medicaid | WA | |
| 911019392 | Other | COMMERCIAL | |
| HE0007 | Other | WA | REGENCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| MD00028899 | WA | MD | Family 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.