Ibrahim Heiba, MD, MPH

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

36260 Issued in TN

Practice address

200 S Wilcox Dr
BLDG 215
Kingsport, TN 37662

Phone

(423) 229-5448

Fax

(423) 229-1684

NPI assigned

Oct 31, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1356520845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WILCOX DR",
            "address_2": "BLDG 215, PO BOX 1975 MEDICAL DEPT",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37662",
            "telephone_number": "423-229-5448",
            "fax_number": "423-229-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WILCOX DR",
            "address_2": "BLDG 215",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37662",
            "telephone_number": "423-229-5448",
            "fax_number": "423-229-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIBA",
        "first_name": "IBRAHIM",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TN",
            "license": "36260",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "SC",
            "license": "27823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heaven at Home Care
• Robin Hebert
• Jennifer Ardemagni Height, PNP
• Christopher T Heitz, MD
• Kimberly M Helms, M.D.
• Adrienne Henegar, CFY-SLP
• Bonnie Henley, FNP

• Occupational Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Occupational Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.