Individual provider Active NPI

Eric Vaughn Heatwole, MD

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
National Provider Identifier
1053382234
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01057573A Issued in IN
Practice address
5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701
Phone
(260) 432-1568
Fax
(260) 432-4969
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01057573A IN Primary

Addresses

Primary practice location

5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701

Mailing address

PO Box 80070
Fort Wayne, IN 46898-0070
Phone (260) 432-1568

Other practice location 1

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 935-8895

Other identifiers 3

IdentifierTypeStateIssuer
2413285MedicaidOH
200423650MedicaidIN
1053382234MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN, OH, DC4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20090402000606 MI Practitioner - Diagnostic Radiology 2769544923 Reassigns benefits to 1 organization
I20090928000270 IN Practitioner - Diagnostic Radiology 2769544923 Reassigns benefits to 13 organizations
I20131017000961 OH Practitioner - Diagnostic Radiology 2769544923 Reassigns benefits to 1 organization
I20250211000334 DC Practitioner - Diagnostic Radiology 2769544923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry County Memorial HospitalGroup PAC ID 6002724085, 153 clinicians
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians
X-Ray Physicians of Shelbyville PCGroup PAC ID 2264420215, 43 clinicians
Spectrum Healthcare Partners PAGroup PAC ID 7618871245, 305 clinicians
Gainesville Radiology Group PCGroup PAC ID 9335046382, 65 clinicians
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians
Greene County General HospitalGroup PAC ID 2961481544, 102 clinicians
Summit Radiology P CGroup PAC ID 0143295410, 101 clinicians
Pacific Imaging Associates LLCGroup PAC ID 3577923499, 69 clinicians
American Oncology Partners PAGroup PAC ID 0042569758, 377 clinicians

Practice addresses (Care Compare)

1000 N 16TH St
New Castle, IN 47362-4319
Phone (765) 521-0890

10630 Saddlebrook CT
Fort Wayne, IN 46814-9315
Phone (269) 781-4271

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

1185 N 1000
Linton, IN 47441-5282
Phone 81284722812054

200 N Madison St
Marshall, MI 49068-1143

2209 Turnberry LN
Fort Wayne, IN 46814-9354
Phone (269) 781-4271

5001 US Hwy 30 W D
Fort Wayne, IN 46818-9701
Phone (260) 432-1568

6245 S 455
Wolcottville, IN 46795-9499
Phone (503) 413-7800

7467 Flutter Rd
Fort Wayne, IN 46835-9238
Phone (269) 781-4271

7910 W Jefferson Blvd
Suite 108
Fort Wayne, IN 46804-4159
Phone (260) 436-0800

916 Myrtle St
Sturgis, MI 49091-2326
Phone (269) 659-4482

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01057573AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Healthcare Associates Inc Diagnostic Radiology CurrentSince May 25, 2025 Accepting new patients
Greene County General Hospital Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients
Henry County Memorial Hospital Current Accepting new patients
Tulsa X-Ray Laboratory PLLC Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Jul 1, 2020 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology Current Accepting new patients
Summit Radiology P C Diagnostic Radiology CurrentSince Jul 1, 2003 Accepting new patients
Henry County Memorial Hospital CurrentSince Mar 22, 2017 Accepting new patients
Direct Imaging LLC CurrentSince Jun 16, 2017 Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Mar 24, 2025 Accepting new patients
Ella E M Brown Charitable Circle Diagnostic Radiology CurrentSince Feb 23, 2025 Accepting new patients
Greene County General Hospital Current Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Jan 1, 2025 Accepting new patients
Gainesville Radiology Group, PC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
American Oncology Partners PA Diagnostic Radiology CurrentSince Jan 2, 2025 Accepting new patients
Henry County Memorial Hospital CurrentSince Mar 22, 2017 Accepting new patients
Dimensions Healthcare Associates Inc CurrentSince Jan 1, 2025 Accepting new patients
X-Ray Physicians of Shelbyville PC Diagnostic Radiology CurrentSince Nov 1, 2021 Accepting new patients
Major Hospital Current Accepting new patients
St. Joseph Health System, LLC Past Accepting new patients
Imaging Diagnostic Center Limited Diagnostic Radiology Past Accepting new patients
Northwest Ohio Urgent Care Inc Past Accepting new patients

Locations (25 of 31)

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

108 Prominence Ct
Ste 120
Dawsonville, GA 30534
Phone (706) 344-6944

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

316 N Broad St
Ste 230
Winder, GA 30680

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

26 Six Pine Ranch Rd
Batesville, IN 47006
Phone (812) 934-5252

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

5001 US Highway 30 W
Ste D
Fort Wayne, IN 46818
Phone (260) 469-8273

7221 Engle Rd
Ste 220
Fort Wayne, IN 46804
Phone 26043215688225

5001 US Highway 30 W
#D
Fort Wayne, IN 46818
Phone (808) 599-4471

7910 W Jefferson Blvd
Ste 108
Fort Wayne, IN 46804
Phone (219) 484-8830

7836 W Jefferson Blvd
Ste 101
Fort Wayne, IN 46804
Phone (260) 494-3458

7900 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (219) 426-6667

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

8550 Naab Rd
Ste 205
Indianapolis, IN 46260
Phone (317) 338-6040

1185 N 1000 W
Linton, IN 47441
Phone (812) 847-2281

2200 Forest Ridge Pkwy
New Castle, IN 47362
Phone (765) 521-7385

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 8

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1053382234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80070",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468980070",
            "telephone_number": "260-432-1568",
            "fax_number": "260-432-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 US HIGHWAY 30 W STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189701",
            "telephone_number": "260-432-1568",
            "fax_number": "260-432-4969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Reid Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473741157",
            "country_code": "US",
            "telephone_number": "765-935-8895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEATWOLE",
        "first_name": "ERIC",
        "middle_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01057573A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2413285",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200423650",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053382234",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.