Individual provider Active NPI

Chloe Jane Heydenberk

  • Behavior Technician
  • Grand Rapids, MI
National Provider Identifier
1992353957
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
11 Dwight Ave SE
Grand Rapids, MI 49506-1470
Phone
(616) 915-1560
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

11 Dwight Ave SE
Grand Rapids, MI 49506-1470

Mailing address

11 Dwight Ave SE
Grand Rapids, MI 49506-1470
Phone (616) 915-1560

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1992353957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DWIGHT AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061470",
            "telephone_number": "616-915-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DWIGHT AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061470",
            "telephone_number": "616-915-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYDENBERK",
        "first_name": "CHLOE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.