Active NPI
Tamara Pruette Heacock, OTR/L
- In Home Supportive Care Agency
- Aston, PA
National Provider Identifier
1669725818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- OC003910L
- Practice address
- 3200 Concord Rd
Aston, PA 19014-1931 - Phone
- (610) 859-7833
- NPI assigned
- Oct 24, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | OC003910L | PA | Primary |
Addresses
Primary practice location
3200 Concord Rd
Aston, PA 19014-1931
Mailing address
509 Montana Ave
Aldan, PA 19018-3216
Phone (610) 623-1343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC003910L | PA | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1669725818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 MONTANA AVE",
"city": "ALDAN",
"state": "PA",
"postal_code": "190183216",
"telephone_number": "610-623-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 CONCORD RD",
"city": "ASTON",
"state": "PA",
"postal_code": "190141931",
"telephone_number": "610-859-7833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEACOCK",
"first_name": "TAMARA",
"middle_name": "PRUETTE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "PA",
"license": "OC003910L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.