Individual provider Active NPI

Heather Miranda Dykes, NP-C

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1427419209
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN183310 Issued in GA
Practice address
840 Pine St Ste 990
Macon, GA 31201
Phone
(478) 633-0404
Fax
(478) 633-0805
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN183310 GA Primary

Addresses

Primary practice location

840 Pine St Ste 990
Macon, GA 31201

Mailing address

840 Pine St Ste 990
Macon, GA 31201
Phone (478) 633-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102001651 GA Practitioner - Nurse Practitioner 1951689546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

840 Pine St
Suite 990
Macon, GA 31201-7500
Phone (478) 738-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN183310GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc CurrentSince Oct 1, 2016 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

770 Pine St
Ste 140
Macon, GA 31201
Phone (478) 633-1821

840 Pine St
Fl 9
Macon, GA 31201

840 Pine St
Ste 990
Macon, GA 31201
Phone (478) 633-0404

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: hdykes434549@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1427419209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 990",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-633-0404",
            "fax_number": "478-633-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 990",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-633-0404",
            "fax_number": "478-633-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKES",
        "first_name": "HEATHER",
        "middle_name": "MIRANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN183310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.