Organization Active NPI

Healing Headquarters Inc

  • Family Medicine Physician
  • Mobile, AL
National Provider Identifier
1174411193
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALING HEADQUARTERS INC
Practice address
3090 Dauphin SQ Connector Ste D
Mobile, AL 36607-2500
Phone
(251) 202-3209
NPI assigned
Jun 26, 2025
Last updated
Mar 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Authorized official

Name
Tyler Stout
Title
Director
Phone
(337) 315-7927

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3090 Dauphin SQ Connector Ste D
Mobile, AL 36607-2500

Mailing address

3090 Dauphin SQ Connector Ste D
Mobile, AL 36607-2500
Phone (251) 202-3209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250827002784 AL Part B Supplier - Clinic/Group Practice 4587165071 Receives reassigned benefits from 3 practitioners
Practice locations: Theodore, AL

National Provider Directory

National Provider Directory

Locations

3090 Dauphin Sq Connector
Ste D
Mobile, AL 36607
Phone (251) 202-3209

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1174411193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 DAUPHIN SQ CONNECTOR STE D",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072500",
            "telephone_number": "251-202-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 DAUPHIN SQ CONNECTOR STE D",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072500",
            "telephone_number": "251-202-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HEADQUARTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-26",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "337-315-7927"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.