Individual provider Active NPI

Mark Reid Heckle, MD

  • Clinical Cardiac Electrophysiology Physician
  • Cordova, TN
National Provider Identifier
1497190862
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
54973 Issued in TN
Practice address
57 Germantown CT Ste 100
Cordova, TN 38018-4274
Phone
(901) 435-8550
Fax
(901) 478-0781
NPI assigned
Apr 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000054973 TN
Cardiovascular Disease Physician 207RC0000X 54973 TN
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Cardiac Electrophysiology Physician 207RC0001X 54973 TN Primary

Addresses

Primary practice location

57 Germantown CT Ste 100
Cordova, TN 38018-4274

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171103002716 TN Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 0941440242 Reassigns benefits to 2 organizations
I20211103000397 MS Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 0941440242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Tennessee, HSC, College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

4240 Bethel Rd
Suite 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000054973TNMDInternal Medicine Physician
54973TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Cardiovascular Disease CurrentSince Sep 13, 2021 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Sutherland Cardiology Clinic, P.C. Current Accepting new patients

Locations

4250 Bethel Rd
Fl 5
Olive Branch, MS 38654
Phone (662) 932-9544

4240 Bethel Rd
Ste 201
Olive Branch, MS 38654

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

57 Germantown Ct
Ste 100
Cordova, TN 38018
Phone (901) 435-8550

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: mheckle30454@mlh.direct-ci.com
  • Direct secure messaging: markheckle@sccpc.allscriptsdirect.net

Organizations & group practices 3

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.

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1497190862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT STE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184274",
            "telephone_number": "901-435-8550",
            "fax_number": "901-478-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKLE",
        "first_name": "MARK",
        "middle_name": "REID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000054973",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "54973",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "54973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.