Larry Travis Heap, PA-C
Individual provider Active NPI Medical Physician Assistant · Saint Johns, AZ
NPI 1366418113 · NPPES record last updated Sep 9, 2026
Key facts
- NPI
- 1366418113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 3048 (AZ)
- Practice address
- 625 N 13TH W
Saint Johns, AZ 85936-4986 - Phone
- (928) 337-3000
- Fax
- (928) 532-3561
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Active Vital Care LLC
Summit Healthcare Medical Associates
Practice addresses (Care Compare)
1928 E Highland Ave
Suite F104
Phoenix, AZ 85016-4626
Phone (833) 242-0100
625 N 13TH
St Johns, AZ 85936-1019
Phone (928) 337-3000
Hospital & facility affiliations
- Home Health Safford, LLC
- White Mountain Regional Medical Center
- Summit Healthcare Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050401000473 | AZ | Practitioner - Physician Assistant | 5991752909 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3048 | AZ | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Healthcare Medical Associates | Current |
Accepting new patients | |
| Summit Healthcare Association | Physician Assistant | Current | Accepting new patients |
| Summit Healthcare Medical Associates | Current |
Accepting new patients | |
| Summit Healthcare Medical Associates | Current |
Accepting new patients | |
| Summit Healthcare Association | Past | Accepting new patients | |
| Scott R Hamblin MD, PC | Past | Accepting new patients | |
| Summit Healthcare Medical Associates | Physician Assistant | Past | Accepting new patients |
Locations
4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700
1121 S Main St
Snowflake, AZ 85937
Phone (928) 532-3008
Interoperability endpoints
- larryheap@shrmcshma.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3048 | AZ | Yes |
Addresses
Primary practice location
625 N 13TH W
Saint Johns, AZ 85936-4986
Mailing address
625 N 13TH W
Saint Johns, AZ 85936-4986
Phone (928) 337-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 933467 | Medicaid | AZ |
Other providers in Saint Johns, AZ
- Kimberly Dawn Farmer
- Brittany Gray
- Wendy Lynne Guffey
- Hancock Comprehensive Dentistry
- Adelle Hancock
- Hinkson Assisted Living Center
- Ashley Kelepolo
- Little Colorado Behavioral Health Center Inc.
- Little Colorado Behavioral Health Center Inc.
- Daisy Morales
All providers in Saint Johns, AZ · Medical Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.