Dr J Heaven, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1780 Issued in GA

Legal business name

DR J HEAVEN, PC

Practice address

5653 Buford Hwy NE
Doraville, GA 30340-1200

Phone

(770) 396-2969

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Jason Heaven, O.D.NPI 1285703348

Title

President

Phone

(770) 396-2969

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Marc Heaven, O.D.

  • Optometrist
  • Doraville, GA
  • NPI 1285703348
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1780731950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5653 BUFORD HWY NE",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303401200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5653 BUFORD HWY NE",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303401200",
            "telephone_number": "770-396-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR J HEAVEN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "HEAVEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-396-2969",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Daniel Denson Jr.
• Nadya K Dhanani
• Matthew Michael Diduro, D.C.
• Robert Gwyn Dillon, M.D.
• Doraville Medical Center Corp
• Lester Drezek, O.D.
• Egb Legacy Group, LLC
• Element Acupuncture Inc.
• Elite Medcare, LLC
• Elite Pain Care, LLC

• Optometrist in Doraville, GA
• Providers in Doraville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.