NPIMap

Individual provider Active NPI

Larry Travis Heap, PA-C

  • Medical Physician Assistant
  • Saint Johns, AZ
National Provider Identifier
1366418113
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3048 Issued in 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
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3048 AZ Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000473 AZ Practitioner - Physician Assistant 5991752909 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 3870942428, 19 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3048AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates CurrentSince Oct 1, 2016 Accepting new patients
Summit Healthcare Association Physician Assistant Current Accepting new patients
Summit Healthcare Medical Associates CurrentSince Oct 1, 2016 Accepting new patients
Summit Healthcare Association Past Accepting new patients
Summit Healthcare Medical Associates Physician Assistant Past Accepting new patients
Scott R Hamblin MD, PC Past Accepting new patients

Locations

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 532-3926

1121 S Main St
Snowflake, AZ 85937
Phone (928) 532-3008

Interoperability endpoints

  • Direct secure messaging: larryheap@shrmcshma.allscriptsdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1366418113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N 13TH W",
            "city": "SAINT JOHNS",
            "state": "AZ",
            "postal_code": "859364986",
            "telephone_number": "928-337-3000",
            "fax_number": "928-532-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 13TH W",
            "city": "SAINT JOHNS",
            "state": "AZ",
            "postal_code": "859364986",
            "telephone_number": "928-337-3000",
            "fax_number": "928-532-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAP",
        "first_name": "LARRY",
        "middle_name": "TRAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, AZ

Sources for this page

Verify at the official NPI Registry.