Kenneth A Heiles, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R3681 Issued in AR

Practice address

203 S Jefferson St
Star City, AR 71667-5101

Phone

(793) 229-5764

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Arkansas for Medical Sciences

  dba Kenneth Heiles Clinic AHEC

  • Family Medicine Physician
  • Star City, AR
  • NPI 1336184431
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1184660698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SEVEN HILLS DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090235",
            "telephone_number": "352-666-6950",
            "fax_number": "352-666-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S JEFFERSON ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675101",
            "telephone_number": "793-229-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILES",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R3681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112297003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeri Lou Farabough, SLP
• Gardner Health, LLC (Gardner Nursing Center)
• Gardner Nursing Opco LLC (Gardner Nursing and Rehabilitation)
• Skylar Michelle Garner, DDS
• GNC of Star City Inc (Gardner Nursing Center)
• Toni L Hobbs, BS, MHPP
• Soundra M Hogg
• Chasity Nichole Hooks, RN
• Jefferson Hospital Association, Inc
• Patricia Royals Jenkins, PD

• Family Medicine Physician in Star City, AR
• Providers in Star City, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.