Organization Active NPI

Heekin Clinic LLC

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1235533829
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
HEEKIN CLINIC LLC
Practice address
1045 Riverside Ave Ste 100
Jacksonville, FL 32204-4148
Phone
(904) 328-5979
Fax
(904) 619-9925
NPI assigned
Oct 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Fady El Bahri, MDNPI 1780778308
Title
Owner
Phone
(904) 328-5979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X ME49020 FL

Addresses

Primary practice location

1045 Riverside Ave Ste 100
Jacksonville, FL 32204-4148

Mailing address

1045 Riverside Ave Ste 100
Jacksonville, FL 32204-4148
Phone (904) 328-5979

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.

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1235533829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 RIVERSIDE AVE STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044148",
            "telephone_number": "904-328-5979",
            "fax_number": "904-619-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 RIVERSIDE AVE STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044148",
            "telephone_number": "904-328-5979",
            "fax_number": "904-619-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEEKIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "EL BAHRI",
        "authorized_official_first_name": "FADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-328-5979",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME49020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.