Kelli Nicole Heer, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 803 Issued in AL

Practice address

106 Westside Dr
Dothan, AL 36303-1908

Phone

(877) 231-3376

Fax

(850) 522-8354

NPI assigned

Dec 20, 2011

Last updated

Oct 12, 2020By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Health of Dothan, P.C.Group PAC ID 3072905157, 4 clinicians

Affiliated Dermatology, PCGroup PAC ID 2163401332, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelliheer@dermdothan.emadirect.md

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.

• Affiliated Dermatology, PC

  • Procedural Dermatology Physician
  • Dothan, AL
  • NPI 1124008636
  Medicare reassignment Care Compare group
• Dermatology and Skin Health of Dothan PC

  • Dermatology Physician
  • Dothan, AL
  • NPI 1437825742
  Medicare reassignment Care Compare group
• Southeastern Dermatology Group PA

  dba Dermatology Specialists

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231

  AL

  Medicare reassignment
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1134498132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "877-231-3376",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEER",
        "first_name": "KELLI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-20",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA 803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL PHYSICIAN ASSISTANT",
            "identifier": "PA.803",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healthwest Dental, PC
• Matthew William Heard, M.S., L.P.C.
• Hearing Associates of Dothan, LLC
• Hearts South, PC
• Carole Elizabeth Heath, CNM
• Bayne Hillen Heersink, DMD
• Juanita Titrud Heersink, M.D.
• Marius Jan Heersink
• Marnix E Heersink, MD
• Sebastian B Heersink, MD

• Surgical Physician Assistant in Dothan, AL
• Providers in Dothan, AL by specialty
• Surgical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.