Glenn Craig Heigerick, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

024947 Issued in GA

Practice address

615 Beaver Ruin Rd NW
Suite B
Lilburn, GA 30047-3401

Phone

(770) 935-8616

Fax

(770) 935-8549

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2020 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: craig.heigerick@538504950906884.direct.elationemr.com
• Direct secure messaging: glenn.heigerick@450151672053764.direct.elationemr.com

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.

• G Craig Heigerick DO PC

  • Family Medicine Physician
  • Lilburn, GA
  • NPI 1417139403
  NPD Authorized official
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1487715298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 BEAVER RUIN RD NW STE B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-935-8616",
            "fax_number": "770-935-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BEAVER RUIN RD NW",
            "address_2": "SUITE B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-935-8616",
            "fax_number": "770-935-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIGERICK",
        "first_name": "GLENN",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "024947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aeryka Miche'Le Harvey, MPH, OMS4, CD
• Thaddeus Harvey Jr., DDS
• Aimon Hazari, OD
• Melodie Anne (Or Desanto) Head
• Hear Better Holdings of Gwinnett (Audiology Associates of GA)
• Rebecca Campbell Henderson, MSN, FNP-C
• Uyen Ho Hernandez, PHARMD
• Camelia Hicks
• Jerica Demetrus Hicks
• Steven Thomas Hightshue, PT, DPT

• Family Medicine Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.