Individual provider Active NPI

Anthony James Heidt, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Okemos, MI
National Provider Identifier
1770907867
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
5101022939 Issued in MI
Practice address
2154 Commons Pkwy
Okemos, MI 48864-3986
Phone
(517) 657-7906
Fax
(517) 657-7908
NPI assigned
Feb 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101022939 MI Primary
General Practice Physician 208D00000X 0102204454 VA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2154 Commons Pkwy
Okemos, MI 48864-3986

Mailing address

2154 Commons Pkwy
Okemos, MI 48864-3986
Phone (517) 657-7906

Other practice location 1

10020 Korengal Valley Blvd
141
Fort Drum, NY 13602-0000
Phone (315) 772-5587

Other practice location 2

4660 S Hagadorn Rd Ste 500
East Lansing, MI 48823-6804
Phone (517) 432-6144

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823002567 MI Practitioner - Osteopathic Manipulative Medicine 6204219306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whole Being Therapy PLCGroup PAC ID 0345557757, 3 clinicians

Practice addresses (Care Compare)

2154 Commons Pkwy
Okemos, MI 48864-3986
Phone (517) 657-7906

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101022939MIMDNeuromusculoskeletal Medicine & OMM Physician
0102204454VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manzano-Nunn, PLLC CurrentSince Jul 5, 2022 Accepting new patients
Whole Being Therapy, PLC Neuromusculoskeletal Medicine & Omm CurrentSince Jul 5, 2022 Accepting new patients
Whole Being Therapy Current Accepting new patients

Locations

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

2154 Commons Pkwy
Okemos, MI 48864
Phone (517) 657-7906

Organizations & group practices 3

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 2

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": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1770907867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 COMMONS PKWY",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643986",
            "telephone_number": "517-657-7906",
            "fax_number": "517-657-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 COMMONS PKWY",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643986",
            "telephone_number": "517-657-7906",
            "fax_number": "517-657-7908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10020 Korengal Valley Blvd",
            "address_2": "141",
            "address_purpose": "LOCATION",
            "city": "Fort Drum",
            "state": "NY",
            "postal_code": "136020000",
            "country_code": "US",
            "telephone_number": "315-772-5587",
            "fax_number": "315-772-5703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236804",
            "country_code": "US",
            "telephone_number": "517-432-6144",
            "fax_number": "517-432-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDT",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101022939",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102204454",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.