Gregory Heeter, M.S., ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL3938 Issued in FL

Practice address

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568

Phone

(904) 858-7045

Fax

(904) 858-7047

NPI assigned

Jan 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1073902623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEETER",
        "first_name": "GREGORY",
        "credential": "M.S., ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Hedstrom
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• Heekin Orthopedic Joint Replacement Specialist
• Jennifer Ann Heery, N.P.
• Savannah N. Heesacker, APRN
• Nicolette L Heeter
• Daniel Heffes, DDS
• Madison Nicole Hefner
• Monique Terri Heggs
• Michael Heid, DO

• Athletic Trainer in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.