Individual provider Active NPI

Heather Lynn Koniarczyk, NP-C

  • Adult Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1992084297
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.12507 Issued in OH
Practice address
10201 Carnegie Ave
Ca6-61
Cleveland, OH 44106-2130
Phone
(216) 618-2230
NPI assigned
Aug 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.12507 OH Primary

Addresses

Primary practice location

10201 Carnegie Ave
Ca6-61
Cleveland, OH 44106-2130

Mailing address

6890 Bridgecreek Dr
Concord TWP, OH 44077-2355
Phone (440) 655-5911

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.12507OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hkoniarczyk143689@direct.ccf.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1992084297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6890 BRIDGECREEK DR",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440772355",
            "telephone_number": "440-655-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 CARNEGIE AVE",
            "address_2": "CA6-61",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441062130",
            "telephone_number": "216-618-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIARCZYK",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.