Jimmy D. Heath Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MDR5A39 Issued in MO

Practice address

320 N Lincoln St
East Prairie, MO 63845-1160

Phone

(573) 649-3026

Fax

(573) 649-5600

NPI assigned

Jan 5, 2006

Last updated

Mar 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Francis Medical Center

  dba Saint Francis Medical Center Anesthesia

  • Anesthesiology Physician
  • Cape Girardeau, MO
  • NPI 1356304489
  Medicare reassignment NPD
• Saint Francis Medical Center

  dba Kneibert Clinic

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1356706378

  Family Medicine

  NPD
• Saint Francis Medical Center

  dba Saint Francis Laboratory Sikeston

  • Clinical Medical Laboratory
  • Sikeston, MO
  • NPI 1588340194
  NPD
• Saint Francis Medical Center

  dba Saint Francis Clinic Jackson

  • Clinic/Center
  • Jackson, MO
  • NPI 1992502975
  NPD
• Bertrand Nursing & Rehab Ctr LLC

  • Skilled Nursing Facility
  • Bertrand, MO
  • NPI 1104254218
  NPD (past)
• Mississippi County Health Department

  • Public Health or Welfare Agency
  • Charleston, MO
  • NPI 1023210648
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1679551063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N LINCOLN ST",
            "city": "EAST PRAIRIE",
            "state": "MO",
            "postal_code": "638451160",
            "telephone_number": "573-649-3026",
            "fax_number": "573-649-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "JIMMY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MDR5A39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NUMBER",
            "identifier": "430741410",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO NUMBER",
            "identifier": "23178",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201199429",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK NUMBER",
            "identifier": "124804",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "43074141063801A002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ferguson Medical Group
• Ferguson Medical Group Rural Health Center Inc
• Bethany Ferrell
• Claire E Grisham, FNP
• Rebecca Camille Hatton, COTA/L
• Patricia Hogan, RPH
• Bryan Hubbard, PHARMD.
• Main Street Pharmacy LLC (Main Street Pharmacy)
• Main Street Pharmacy LLC.
• Main Street RX (Main Street Pharmacy)

• Family Medicine Physician in East Prairie, MO
• Providers in East Prairie, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.