Stanton Paul Heydinger, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

T-5312 Issued in MS

Practice address

764 Lakeland Dr
Jackson, MS 39216-4651

Phone

(601) 984-5020

NPI assigned

Jun 6, 2020

Sex

Male

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1591401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1174147003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 COPPER RIDGE CT",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164651",
            "telephone_number": "601-984-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYDINGER",
        "first_name": "STANTON",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-06",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "T-5312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Ates Hewes
• Carla C. Hewitt, MD
• Justin Hewitt, ATC
• Ronald Hewitt
• Madison Brooke Heydinger, DO
• Aubri Bailey Hickman, FNP-C
• Jeffrey Bryan Hickman, LPC
• Patricia Ann Hickman, SOCIAL WORKER
• Tyrah Patrice Hickman, NP
• Harrison Clark Hicks

• Ophthalmology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Ophthalmology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.