Individual provider Active NPI

Heather Erin Tyndall, PA

  • Physician Assistant
  • Kinston, NC
National Provider Identifier
1740361369
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00617 Issued in NC
Practice address
744 Airport Road
Kinston, NC 28504-8800
Phone
(252) 523-0026
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00617 NC Primary

Addresses

Primary practice location

744 Airport Road
Kinston, NC 28504-8800

Mailing address

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6740

Other identifiers 2

IdentifierTypeStateIssuer
1653MOtherNCBCBS
8102516MedicaidNC

Other names 1

  • Heather Erin Cronkhite Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081122000053 NC Practitioner - Physician Assistant 5395805204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians East PAGroup PAC ID 1850284571, 104 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

152 Crossover Rd
Beulaville, NC 28518-8800
Phone (910) 298-4688

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6641

2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818

744 Airport Rd
Kinston, NC 28504-8800
Phone (252) 523-0026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00617NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians East, PA CurrentSince Jun 1, 2014 Accepting new patients

Locations

152 Crossover Rd
Beulaville, NC 28518
Phone (910) 298-4688

201 North Main St
Farmville, NC 27828
Phone (252) 753-4181

1850 W Arlington Blvd
Greenville, NC 27834
Phone (252) 413-6641

905 Johns Hopkins Dr
Greenville, NC 27834
Phone (252) 744-1406

744 Airport Rd
Kinston, NC 28504
Phone (252) 523-0026

4796 Old Tar Rd
Winterville, NC 28590
Phone (252) 353-4111

Interoperability endpoints

  • Direct secure messaging: heathertyndall@pepa.medalliesdirect.net

Organizations & group practices 2

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 6

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1740361369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-413-6740",
            "fax_number": "252-752-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 AIRPORT ROAD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285048800",
            "telephone_number": "252-523-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALL",
        "first_name": "HEATHER",
        "middle_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1653M",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102516",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CRONKHITE",
            "middle_name": "ERIN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.