Gregg A Heatley, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29449 Issued in WI

Practice address

3844 Swoboda Rd
Verona, WI 53593-8416

Phone

(608) 821-3182

NPI assigned

Feb 24, 2006

Last updated

Sep 15, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1194791616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 SWOBODA RD",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535938416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3844 SWOBODA RD",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535938416",
            "telephone_number": "608-821-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATLEY",
        "first_name": "GREGG",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "29449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gheatley22157@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2880 University Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537053644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ophthalmology Physician in Verona, WI
• Providers in Verona, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.