Individual provider Active NPI

Mary Margaret Heatley, PA-C

  • Physician Assistant
  • Waterloo, IA
National Provider Identifier
1134180870
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000927 Issued in IA
Practice address
2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047
Phone
(319) 272-2112
Fax
(319) 272-2107
NPI assigned
Mar 31, 2006
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000927 IA Primary

Addresses

Primary practice location

2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047

Mailing address

3421 W 9TH St
Waterloo, IA 50702-5401
Phone (319) 272-7304

Other names 1

  • Meg Heatley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates PC CurrentSince Aug 11, 1997 Accepting new patients
Iowa Physicians Clinic Medical Foundation Past Accepting new patients

Locations

3812 Pheasant Ln
Waterloo, IA 50701
Phone (319) 236-3444

Interoperability endpoints

  • Direct secure messaging: mary.heatley@cvms.eclinicaldirectplus.com

Organizations & group practices 2

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1134180870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE STE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATLEY",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "000927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEG",
            "last_name": "HEATLEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.