Active NPI
Emily Heasley, M.D.
- Obstetrics & Gynecology Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 01078476A
- Practice address
- 211 N Eddy St
South Bend, IN 46617-3096 - Phone
- (574) 234-8161
- NPI assigned
- Jun 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 01078476A | IN | Primary |
Addresses
Primary practice location
211 N Eddy St
South Bend, IN 46617-3096
Mailing address
211 N Eddy St
South Bend, IN 46617-3096
Phone (574) 234-8161
Other names 1
- Emily Starrick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Indiana University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14950 State Rd
Suite 23
Granger, IN 46530-7564
Phone (574) 234-8161
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01078476A | IN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The South Bend Clinic LLC | Current | Accepting new patients | |
| The South Bend Clinic, LLC | Current | Accepting new patients |
Locations
14950 State Road 23
Granger, IN 46530
Phone (574) 243-2221
5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443
6301 University Commons
Ste 310
South Bend, IN 46635
Phone (574) 232-1471
714 N Michigan St
South Bend, IN 46601
Phone (574) 647-7477
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
Interoperability endpoints
- eheasley1263833@direct.trinity-health.org
- eheasley256598@dulyhealthandcare.direct-ci.com
- https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
Organizations & group practices 2
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.
-
- Clinic/Center
- South Bend, IN
- NPI 1073680419
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1487307492
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1295174530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 N EDDY ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466173096",
"telephone_number": "574-234-8161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 N EDDY ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466173096",
"telephone_number": "574-234-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEASLEY",
"first_name": "EMILY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-20",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "01078476A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "STARRICK",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.