Individual provider Active NPI

Stewart Nicholas Heaton, AA

  • Anesthesiologist Assistant
  • La Crosse, WI
National Provider Identifier
1043611320
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
44 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Sep 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 44 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190916000505 FL Practitioner - Anesthesiology Assistant 8921229105 Reassigns benefits to 1 organization
I20210222001707 GA Practitioner - Anesthesiology Assistant 8921229105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (404) 466-1170

Hospital & facility affiliations

  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
10220GAMDGeneral Practice Dentistry
44WIMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates MD PA CurrentSince Sep 1, 2020 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Feb 1, 2021 Accepting new patients

Locations

567 Avenue K SE
Winter Haven, FL 33880
Phone (863) 299-1231

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

4500 Hospital Blvd
Ste 210
Roswell, GA 30076

4441 Atlanta Rd SE
Ste 312
Smyrna, GA 30080
Phone (470) 956-4200

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1043611320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "STEWART",
        "middle_name": "NICHOLAS",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.