Individual provider Active NPI

W Kate Heberle, M.D.

  • Anesthesiology Physician
  • Brunswick, GA
National Provider Identifier
1053412031
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
69325 Issued in GA
Practice address
2301 Parkwood Dr
Brunswick, GA 31520-4720
Phone
(912) 264-0014
NPI assigned
Sep 25, 2006
Last updated
Apr 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD21387 OR
Anesthesiology Physician 207L00000X 69325 GA Primary

Addresses

Primary practice location

2301 Parkwood Dr
Brunswick, GA 31520-4720

Mailing address

122 Rice ML
St Simons Island, GA 31522-5415
Phone (912) 222-8281

Other names 1

  • Wendi Lesser Heberle Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69325GAMDAnesthesiology Physician
MD21387ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants of Fresno Anesthesiology PastSince Sep 17, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1053412031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 RICE ML",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225415",
            "telephone_number": "912-222-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204720",
            "telephone_number": "912-264-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERLE",
        "first_name": "W",
        "middle_name": "KATE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD21387",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "69325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDI",
            "last_name": "HEBERLE",
            "middle_name": "LESSER",
            "credential": "M/D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.