Individual provider Active NPI

Zebulon Heidt, D.O.

  • Emergency Medicine Physician
  • Fort Oglethorpe, GA
National Provider Identifier
1215463567
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101023590 Issued in MI
Practice address
100 Gross Crescent Cir
Fort Oglethorpe, GA 30742-3643
Phone
(706) 858-2000
NPI assigned
May 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4093 TN
Emergency Medicine Physician 207P00000X 5101023590 MI Primary

Addresses

Primary practice location

100 Gross Crescent Cir
Fort Oglethorpe, GA 30742-3643

Mailing address

100 Gross Crescent Cir
Fort Oglethorpe, GA 30742-3643
Phone (248) 338-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, GA, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191108001308 MI Practitioner - Emergency Medicine 3375813439 Reassigns benefits to 1 organization
I20200611002425 GA Practitioner - Emergency Medicine 3375813439 Reassigns benefits to 1 organization
I20200819002452 TN Practitioner - Emergency Medicine 3375813439 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Emergency Medicine PLLC CurrentSince Sep 13, 2022 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Sep 13, 2022 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Degara App, PLLC Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

2110 S M 76
West Branch, MI 48661
Phone (989) 345-4884

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1215463567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GROSS CRESCENT CIR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423643",
            "telephone_number": "248-338-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GROSS CRESCENT CIR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423643",
            "telephone_number": "706-858-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDT",
        "first_name": "ZEBULON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "4093",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101023590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

Verify at the official NPI Registry.