Heather L Dudley, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS14575 Issued in FL

Practice address

1658 St Vincents Way Ste 130
Middleburg, FL 32068-8459

Phone

(904) 264-1628

Fax

(904) 264-8386

NPI assigned

Jan 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Heather L Coker Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: heather.dudley.1@8967.direct.athenahealth.com

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.

• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Boca Raton, FL
  • NPI 1710647334
  Medicare reassignment Care Compare group NPD
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Obstetrics & Gynecology

  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Florida Woman Care, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1386823243
  Medicare reassignment
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Melbourne, FL
  • NPI 1245472661
  NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Winter Haven, FL
  • NPI 1851282016
  NPD
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Womencare PA

  • Specialist
  • Orlando, FL
  • NPI 1366529042
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1356320592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 130",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688459",
            "telephone_number": "904-264-1628",
            "fax_number": "904-264-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 130",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688459",
            "telephone_number": "904-264-1628",
            "fax_number": "904-264-8386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Kingsley Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320739200",
            "country_code": "US",
            "telephone_number": "904-264-1628",
            "fax_number": "904-264-8386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "HEATHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036113156",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS14575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356320592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "COKER",
            "middle_name": "L",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheri Yvonne Doval, LCSW
• Dollores Louise Doyle, RN
• Dr. Hyler OB/GYN and Associates, LLC
• Dream Care LLC
• DRS. McClow, Clark & Berk PA
• Sabian Dupree
• Stacey D Dure
• Malisa Selina Dwyer, LCSW
• Deborah East
• Billie J Ebersole

• Obstetrics & Gynecology Physician in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.

Verify at the official NPI Registry.