Heather J. Johnson, MD
Individual provider Active NPI Pediatrics Physician · Owensboro, KY
NPI 1154767176 · NPPES record last updated Apr 18, 2017
Key facts
- NPI
- 1154767176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 49491 (KY)
- Practice address
- 1201 Pleasant Valley Rd
7TH Floor
Owensboro, KY 42303-9811 - Phone
- (270) 417-4705
- Fax
- (270) 417-4709
- NPI assigned
- May 16, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161104001500 | KY | Practitioner - Pediatric Medicine | 7911296785 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Owensboro Health Medical Group, Inc | Current |
Accepting new patients | |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| Owensboro Health Medical Group Inc | Current |
Accepting new patients | |
| Owensboro Health Inc | Past | Accepting new patients | |
| Owensboro Pediatrics LLC | Pediatrics | Past | Accepting new patients |
Locations
2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351
1201 Pleasant Valley Rd
Fl 7
Owensboro, KY 42303
Phone (270) 417-4705
1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | TP357 | KY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 49491 | KY | Yes |
Addresses
Primary practice location
1201 Pleasant Valley Rd
7TH Floor
Owensboro, KY 42303-9811
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100418510 | Medicaid | KY |
Other names
- Heather J. Bowers
Other providers in Owensboro, KY
- Corey Morgan Johnson
- Dasjarae Brior Johnson
- David Joseph Johnson
- Evan Johnson
- Guscilla Johnson
- James Michael Johnson
- Jordon Johnson
- Julie B Johnson
- Kimberly Janell Johnson
- Kyle Gregory Johnson
All providers in Owensboro, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.