Kevin A Heintzelman, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20864 Issued in MS

Practice address

1200 N State St
Suite 480
Jackson, MS 39202-2001

Phone

(601) 352-2273

Fax

(601) 714-3415

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation of Central Mississippi IncGroup PAC ID 1153216411, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kheintzelman148999@direct.bmhcc.org
• Direct secure messaging: kevin_a_heintzelman_do@yourcarecommunity.org

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.

• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment Care Compare group NPD
• Medical Foundation of Central Ms

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Mississippi Homecare of Jackson II, LLC

  • Home Health Agency
  • Jackson, MS
  • NPI 1730373275
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1184701344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39225",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE 480",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022001",
            "telephone_number": "601-352-2273",
            "fax_number": "601-714-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZELMAN",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "224633",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "20864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02272493",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03658704",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yassmin Hegazy, MD
• Jennifer Clair Heggie, LPC-S, NCC
• Amy Heidelberg, FNP-C
• Philip Heine, PT
• Jane Katherine Heinold, DO
• Diana Heise
• Thomas Helling, MD
• Kelsey Lynn Helm
• Wilson Woodward Helmhout, MD
• Charles D Helms, CRNA

• Internal Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.