Jessica Eleanor Heron, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008552 Issued in MI

Practice address

1391 E Parkdale Ave
Manistee, MI 49660-9352

Phone

(231) 398-1760

Fax

(231) 398-1768

NPI assigned

Feb 1, 2018

Sex

Female

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 MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Munson Healthcare Manistee Hospital

  • General Acute Care Hospital
  • Manistee, MI
  • NPI 1407949191
  Medicare reassignment NPD
• Munson Healthcare Manistee Hospital

  • Surgery Physician
  • Manistee, MI
  • NPI 1861577389
  NPD

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1770081002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609352",
            "telephone_number": "231-398-1760",
            "fax_number": "231-398-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609352",
            "telephone_number": "231-398-1760",
            "fax_number": "231-398-1768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6227 Frankfort Hwy",
            "address_purpose": "LOCATION",
            "city": "Benzonia",
            "state": "MI",
            "postal_code": "496168632",
            "country_code": "US",
            "telephone_number": "231-882-9661",
            "fax_number": "231-882-9616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERON",
        "first_name": "JESSICA",
        "middle_name": "ELEANOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "5601008552",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harmony Family Center LLC
• Annette Sue Hart
• Heidi Boehm Chiropractic LLC
• James Ben Hengy, D.O.
• Chantelle Heniser
• HM Assisted Living of Manistee, LLC
• Trevor Hodges
• Amy Holtgren, RD
• Dennis Horina, RPH
• Kristen R Howard

• Physician Assistant in Manistee, MI
• Providers in Manistee, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.