Jerry Anderson Heath, PA-C

Individual provider Active NPI Physician Assistant · Hays, NC

NPI 1104860774 · NPPES record last updated Dec 1, 2010

Key facts

NPI
1104860774
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
100336 (NC)
Practice address
5229 Rock Creek Rd
Hays, NC 28635-9267
Phone
(336) 696-2711
Fax
(336) 696-2829
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
100336NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26386/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 100336 NC Yes

Addresses

Primary practice location

5229 Rock Creek Rd
Hays, NC 28635-9267

Mailing address

5229 Rock Creek Rd
Hays, NC 28635-9267
Phone (336) 696-2711

Other providers in Hays, NC

All providers in Hays, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.