Active NPI
Heekin Clinic LLC
- Orthopaedic Surgery Physician
- Jacksonville, FL
National Provider Identifier
1235533829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fady El Bahri, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary | ||
| Adult Reconstructive Orthopaedic Surgery Physician | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1780778308
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.