Heather Haddock, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

34970 Issued in TN

Practice address

1718 Parr Ave Ste E
Dyersburg, TN 38024-2071

Phone

(731) 285-9938

NPI assigned

Oct 27, 2023

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heather Fair Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SHC Medical Partners of Tennessee, LLCGroup PAC ID 1951487826, 21 clinicians

Abode Care Partners LTC VB LLCGroup PAC ID 8325316516, 81 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072

Merit-based Incentive Payment System (MIPS)

Final score

95.74 of 100Reported as apm

Quality

85.23

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hhaddock27947@directepic.wth.org

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

• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Mountain City, TN
  • NPI 1972372225
  Medicare reassignment Care Compare group NPD
• SHC Medical Partners of Tennessee, LLC

  • Nurse Practitioner
  • Mountain City, TN
  • NPI 1609051895
  Medicare reassignment Care Compare group NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Mountain City, TN
  • NPI 1518736834
  Medicare reassignment NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1528871126
  NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Ridgeland, MS
  • NPI 1992518591
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1003688474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 PARR AVE STE E",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242071",
            "telephone_number": "731-285-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 PARR AVE STE E",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242071",
            "telephone_number": "731-285-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "HEATHER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "FAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barry Anthony Greenlee, LMFT
• Gracie M Griffith, PTA
• David P Guthrie, MD
• John Algernon Guthrie, OTR/L
• Katie Gwinn
• Felecia Dawn Hall, P.T.A.
• Christian Halterman, OT
• Cecilia Aundra Hamman, PTA
• Constance Hancox, DOULA
• Hand Surgery Clinic PLLC

• Family Nurse Practitioner in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.