Individual provider Active NPI

Charles E Heth, DO

  • Family Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1336130632
Registry record updated May 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009233 Issued in MI
Practice address
42855 Garfield Rd
Ste 105
Clinton TWP, MI 48038-5027
Phone
(586) 226-1387
Fax
(586) 226-1859
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101009233 MI Primary

Addresses

Primary practice location

42855 Garfield Rd
Ste 105
Clinton TWP, MI 48038-5027

Mailing address

42855 Garfield Rd
Ste 105
Clinton TWP, MI 48038-5027
Phone (586) 226-1387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336780800000",
    "number": "1336130632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42855 GARFIELD RD",
            "address_2": "STE 105",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480385027",
            "telephone_number": "586-226-1387",
            "fax_number": "586-226-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42855 GARFIELD RD",
            "address_2": "STE 105",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480385027",
            "telephone_number": "586-226-1387",
            "fax_number": "586-226-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETH",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2012; 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.