Gary Fletcher Headden, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

15574 Issued in SC

Practice address

171 Ashley Ave
Charleston, SC 29425-8908

Phone

(843) 792-1414

NPI assigned

Aug 29, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in SC

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

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 and National Provider Directory roles.

• Seaside Family Medicine, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1043707557
  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment NPD
• University Medical Associates

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Charleston, SC
  • NPI 1548413453
  NPD
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496
  NPD
• Nason Medical Center IV, LLC

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1689972739
  NPD (past)
• Nason Medical Center V, LLC

  • Urgent Care Clinic/Center
  • Summerville, SC
  • NPI 1427306299
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1720196777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 COLLEGE PARK RD",
            "address_2": "STE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868635",
            "telephone_number": "843-400-0028",
            "fax_number": "843-790-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADDEN",
        "first_name": "GARY",
        "middle_name": "FLETCHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "15574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155744",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lianying He
• Head Dental Associates
• Barbara Head, MD
• Juliana Head, DMD
• Kathleen Claire Head, M.D.
• Kendall Headden, MD
• Kalley Rae Headley, PA-C
• Health First
• Health Touch Pediatric Rehab, LLC
• Healthpitality LLC

• Emergency Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.