Active NPI
Kristy D. Heatly, D.O.
- Family Medicine Physician
- Tomball, TX
National Provider Identifier
1548220122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- L3678
- Practice address
- 13406 Medical Complex Dr
Suite 180
Tomball, TX 77375-3332 - Phone
- (281) 290-0786
- Fax
- (281) 290-0863
- NPI assigned
- Mar 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L3678 | TX | Primary |
Addresses
Primary practice location
13406 Medical Complex Dr
Suite 180
Tomball, TX 77375-3332
Mailing address
13406 Medical Complex Dr
Suite 180
Tomball, TX 77375-3332
Phone (281) 290-0786
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00J21A | Other | TX | GROUP MEDICARE NUMBER |
| 094010801 | Other | TX | GROUP MEDICAID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
9055 Katy Fwy
Suite 200
Houston, TX 77024-1629
Phone (346) 646-4954
Hospital & facility affiliations
- Phoenix Healthcare Services, Inc
- HCA Houston Healthcare Tomball
- Memorial Hermann Hospital System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3678 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMH Physician Associates PLLC | Family Medicine | Current | Accepting new patients |
| Village Family Practice, L.L.P | Family Medicine | Current | Accepting new patients |
| Villagemd of Southeast Texas, PA | Family Medicine | Current | Accepting new patients |
| TMH Physician Associates PLLC | Current | Accepting new patients |
Locations
9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954
9055 Katy Fwy
Ste 200
Houston, TX 77024
Phone (346) 980-2701
16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800
155 School St
Ste 300
Tomball, TX 77375
Phone (281) 255-3838
Interoperability endpoints
- kristy.heatly.1@13711.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Houston, TX
- NPI 1841643327
-
- Orthopaedic Surgery Physician
- Spring, TX
- NPI 1043061351
-
- Family Medicine Physician
- Houston, TX
- NPI 1083619191
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- Tomball, TX
- NPI 1750819025
-
- Home Health Agency
- Houston, TX
- NPI 1558456624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1548220122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13406 MEDICAL COMPLEX DR",
"address_2": "SUITE 180",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773753332",
"telephone_number": "281-290-0786",
"fax_number": "281-290-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13406 MEDICAL COMPLEX DR",
"address_2": "SUITE 180",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773753332",
"telephone_number": "281-290-0786",
"fax_number": "281-290-0863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATLY",
"first_name": "KRISTY",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-27",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "L3678",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE NUMBER",
"identifier": "00J21A",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID NUMBER",
"identifier": "094010801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.
- 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.