Mackenzie A Heywood

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.167992 Issued in IL

Practice address

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401

Phone

(217) 862-0800

Fax

(217) 862-0871

NPI assigned

Mar 25, 2020

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mackenzieheywood@sfc.allscriptsdirect.net

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.

• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930

  Pediatrics

  Medicare reassignment NPD
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Physician Services

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1417922964
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1528741147
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Memorial Expresscare, LLC

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1750532362

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1194352559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St # N5W70",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-5213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "MACKENZIE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0097004",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.167992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "036167992",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Louis Heuermann, MD
• Kerrilyn Hewell, MD
• Jo Marie Hewitt, MD
• Joanna Lyn Hewitt, PTA
• Lindsay Hewitt
• Ruth Hibberd-Anderson II
• Alisea Marie Hibbs, PA
• Anna M Hickey
• Janet Colleen Hickman, LCPC
• Melanie Hicks, PHARMD

• Pediatrics Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.