Gregory D Heaton OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3531 Issued in FL

Legal business name

GREGORY D HEATON OD PA

Doing business as

Jay Vision Center

Practice address

14088 Alabama St
Jay, FL 32565-1036

Phone

(850) 675-0625

NPI assigned

Dec 19, 2007

Last updated

Jun 15, 2022By 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

Angel Kelley

Title

Delegated Official

Phone

(850) 675-0625

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JAY VISION CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 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.

• Gregory D Heaton, OD PA

  • Optometrist
  • Jay, FL
  • NPI 1588605059
  Medicare reassignment NPD

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1003090556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "JAY",
            "state": "FL",
            "postal_code": "325650025",
            "telephone_number": "850-675-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14088 ALABAMA ST",
            "city": "JAY",
            "state": "FL",
            "postal_code": "325651036",
            "telephone_number": "850-675-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY D HEATON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "850-675-0625"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621048100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAY VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Equity RX, PLLC (Equity Rx)
• Gastroenterology Associates of Pensacola PA
• Gastroenterology Associates of Pensacola PA
• Gastroenterology Associates of Pensacola PA
• Linda Glenny
• Hayden Hammond
• Gregory D Heaton, OD PA
• Rhonda L Heflin, OTR/L
• Jennifer M Holland
• J S Michael Smith MD PA

• Optometrist in Jay, FL
• Providers in Jay, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.