Kacy Yevonne Head, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001167A Issued in IN

Practice address

100 Hospital LN
Suite 105
Danville, IN 46122-1989

Phone

(317) 745-3747

Fax

(317) 745-3748

NPI assigned

Mar 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Kacy Yevonne Griffin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Icem, LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1467788208
  NPD (past)
• Urology of Indiana L.L. C.

  • Customized Equipment (DME)
  • Avon, IN
  • NPI 1578961314
  NPD (past)
• Urology of Indiana L.L.C

  • Customized Equipment (DME)
  • Crawfordsville, IN
  • NPI 1740688589
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Franklin, IN
  • NPI 1003996638
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Danville, IN
  • NPI 1104906734
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Greenfield, IN
  • NPI 1275613804
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Lebanon, IN
  • NPI 1447342894
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Mooresville, IN
  • NPI 1487052221
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Noblesville, IN
  • NPI 1669552295
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Shelbyville, IN
  • NPI 1821496662
  NPD (past)
• Urology of Indiana L.L.C.

  • Customized Equipment (DME)
  • Fishers, IN
  • NPI 1912305756
  NPD (past)
• Urology of Indiana, L.L.C.

  • Customized Equipment (DME)
  • Greenwood, IN
  • NPI 1205916830
  NPD (past)

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1003057951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-807-1262",
            "fax_number": "317-859-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL LN",
            "address_2": "SUITE 105",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221989",
            "telephone_number": "317-745-3747",
            "fax_number": "317-745-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "KACY",
        "middle_name": "YEVONNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06217",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001167A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000736707",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "800N55",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202786401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1487680518",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACY",
            "last_name": "GRIFFIN",
            "middle_name": "YEVONNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David M Harsha, MD
• Michael P Hartley, M.D.
• Kevin Michael Hartzell, M.D.
• Lindsey Jewell Haston, MOT, OTR
• Jeanette Marie Hay, NP-C
• Tyler Heavin
• Hedges Family Eyecare, PC
• Kevin Michael Heller, MA, LMHC
• Hendricks Community Hospital
• Hendricks County

• All providers in Danville, IN
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.