Individual provider Active NPI

Nicholas Dalton Heathscott, MD

  • Family Medicine Physician
  • Plant City, FL
National Provider Identifier
1104351626
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME137805 Issued in FL
Practice address
1907 S Alexander St Ste 1
Plant City, FL 33566-0921
Phone
(137) 543-3448
Fax
(813) 754-3574
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME137805 FL Primary

Addresses

Primary practice location

1907 S Alexander St Ste 1
Plant City, FL 33566-0921

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190823000135 FL Practitioner - Family PracticePractitioner - Sports Medicine 7810263605 Reassigns benefits to 1 organization
I20200909001467 AL Practitioner - Sports MedicinePractitioner - Family Practice 7810263605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Arkansas College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

15416 N Florida Ave
Suite 203
Tampa, FL 33613-1244
Phone (813) 723-5450

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Tampa, FL, CCN 103145
  • Baycare Home Care Inc Home health agency, Tampa, FL, CCN 107285
  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME137805FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Aug 9, 2021 Accepting new patients
American Family Care, LLC CurrentSince Nov 21, 2020 Accepting new patients
STV Sports Medicine & Orthopedics LLC Sports Medicine CurrentSince Aug 1, 2020 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Aug 9, 2021 Accepting new patients
STV Sports Medicine & Orthopedics LLC CurrentSince Aug 1, 2020 Accepting new patients
American Family Care, LLC Family Medicine CurrentSince Nov 21, 2020 Accepting new patients

Locations

805 Saint Vincents Dr
Ste 100
Birmingham, AL 35205

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

1652 Montclair Rd
Irondale, AL 35210
Phone (205) 263-8623

7201 Happy Hollow Rd
Ste 202A
Trussville, AL 35173

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

1907 S Alexander St
Ste 1
Plant City, FL 33566
Phone (813) 654-8100

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

15416 N Florida Ave
Tampa, FL 33613
Phone (813) 497-7757

15416 N Florida Ave
Ste 203
Tampa, FL 33613
Phone (347) 463-5529

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: nicholas.heathscott.1@4290.direct.athenahealth.com

Organizations & group practices 6

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 7

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": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1104351626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S ALEXANDER ST STE 1",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335660921",
            "telephone_number": "137-543-3448",
            "fax_number": "813-754-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHSCOTT",
        "first_name": "NICHOLAS",
        "middle_name": "DALTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME137805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.