NPIMap

Organization Active NPI

James K Heacock MD LLC

  • Health Service Clinic/Center
  • Brick, NJ
National Provider Identifier
1235296393
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
MA 34928 Issued in NJ
Legal business name
JAMES K HEACOCK MD LLC
Practice address
1640 Route 88
Suite 203
Brick, NJ 08724-3036
Phone
(732) 458-7777
Fax
(732) 458-6741
NPI assigned
Jan 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Kipp Heacock, MDNPI 1992778153
Title
Owner
Phone
(732) 458-7777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X MA 34928 NJ Primary

Addresses

Primary practice location

1640 Route 88
Suite 203
Brick, NJ 08724-3036

Mailing address

1640 Route 88
Suite 203
Brick, NJ 08724-3036
Phone (732) 458-7777

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235296393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 ROUTE 88",
            "address_2": "SUITE 203",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243036",
            "telephone_number": "732-458-7777",
            "fax_number": "732-458-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 ROUTE 88",
            "address_2": "SUITE 203",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243036",
            "telephone_number": "732-458-7777",
            "fax_number": "732-458-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES K HEACOCK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEACOCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KIPP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-458-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NJ",
            "license": "MA 34928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.