Kenneth a Heiles, D.O. PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R3681 Issued in AR

Legal business name

KENNETH A HEILES, D.O. PLLC

Practice address

203 S Jefferson St
Star City, AR 71667-5101

Phone

(870) 628-5110

Fax

(870) 628-5949

NPI assigned

May 4, 2009

Last updated

Sep 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth A Heiles, D.ONPI 1184660698

Title

Owner/Physician

Phone

(870) 628-5110

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth A Heiles, D.O.

  • Family Medicine Physician
  • Star City, AR
  • NPI 1184660698
  Authorized official Same address or phone

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1003040213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540310",
            "telephone_number": "870-628-5110",
            "fax_number": "870-628-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S JEFFERSON ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675101",
            "telephone_number": "870-628-5110",
            "fax_number": "870-628-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A HEILES, D.O. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "HEILES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "870-628-5110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R3681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112297003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chasity Nichole Hooks, RN
• Jefferson Hospital Association, Inc
• Patricia Royals Jenkins, PD
• Kimberly Johnson, BS, MHPP
• Amanda H Kelley
• Leech Drug Co Inc (Star City Drug Mart)
• Robert William Leech Jr., PD
• Alicia Levengood, PTA
• Mallori Levengood
• Tasha Lewis, LCSW

• Family Medicine Physician in Star City, AR
• Providers in Star City, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.