Active NPI
Heather Nicole Oxentine, M.D.
- Addiction Psychiatry Physician
- Bay Pines, FL
National Provider Identifier
1790042984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- 75427
- Practice address
- 10000 Bay Pines Blvd
Bay Pines, FL 33744-8200 - Phone
- (727) 398-6661
- NPI assigned
- Apr 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 75427 | GA | Primary |
Addresses
Primary practice location
10000 Bay Pines Blvd
Bay Pines, FL 33744-8200
Mailing address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-1406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75427 | GA | MD | Addiction Psychiatry Physician |
| N/A | NC | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680220800000",
"number": "1790042984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342818",
"telephone_number": "252-744-1406",
"fax_number": "252-744-4243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 BAY PINES BLVD",
"city": "BAY PINES",
"state": "FL",
"postal_code": "337448200",
"telephone_number": "727-398-6661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OXENTINE",
"first_name": "HEATHER",
"middle_name": "NICOLE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-12",
"last_updated": "2023-03-31",
"certification_date": "2023-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "GA",
"license": "75427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.