Active NPI
Andrew Russell Heath, DC
- Chiropractor
- Phoenix, AZ
National Provider Identifier
1417060914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3884
- Practice address
- 2322 W Northern Ave
Phoenix, AZ 85021-4935 - Phone
- (602) 242-4930
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3884 | AZ | Primary |
Addresses
Primary practice location
2322 W Northern Ave
Phoenix, AZ 85021-4935
Mailing address
1745 W Laurie LN
Phoenix, AZ 85021-5258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050927000569 | AZ | Practitioner - Chiropractic | 6800821091 | Practice locations: Phoenix, AZ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1983
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2322 W Northern Ave
Phoenix, AZ 85021-4935
Phone (602) 242-4930
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2103 | AZ | MD | Surgical Physician Assistant |
| 3884 | AZ | MD | Child Mental Illness Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417060914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1745 W LAURIE LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850215258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2322 W NORTHERN AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850214935",
"telephone_number": "602-242-4930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "ANDREW",
"middle_name": "RUSSELL",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "3884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.