Heidi Back, RDMS, RVT

Primary specialty

Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X

Practice address

556 Gleneagles Dr
Newark, OH 43055-8644

Phone

(740) 973-8038

NPI assigned

Nov 20, 2019

Last updated

Nov 20, 2019By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1114563541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 GLENEAGLES DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430558644",
            "telephone_number": "740-973-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 GLENEAGLES DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430558644",
            "telephone_number": "740-973-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "HEIDI",
        "credential": "RDMS, RVT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Care Center, Inc.
• Autumn Health Care of Newark
• Autumn Health Care of Thornville, Inc.
• Angela Bacak, PSY.S
• Makayla Bachelor, RN
• Jaclynn Pauline Back, APRN
• Jonathan Kent Bafford, D.C.
• Crea Lynn Bailey
• Ginger Marie Bailey, R.N.
• Leann Bailey

• Radiologic Technologist in Newark, OH
• Providers in Newark, OH by specialty
• Radiologic Technologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.