Active NPI
Heather A Michalak, M.D.
- Pediatrics Physician
- Columbia, TN
National Provider Identifier
1790748994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD44004
- Practice address
- 1600 Nashville Hwy
Columbia, TN 38401 - Phone
- (931) 388-8965
- Fax
- (931) 388-0815
- NPI assigned
- Apr 10, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 238606 | NY | |
| Pediatrics Physician | 208000000X | MD44004 | TN | Primary |
Addresses
Primary practice location
1600 Nashville Hwy
Columbia, TN 38401
Mailing address
1600 Nashville Hwy
Columbia, TN 38401
Phone (931) 388-8965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1511458 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238606 | NY | MD | Pediatrics Physician |
| MD44004 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Pediatric Clinic, Inc. | Past | Accepting new patients | |
| Maury Regional Hospital | Past | Accepting new patients |
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.
-
- Primary Care Clinic/Center
- Columbia, TN
- NPI 1023146099
-
- General Acute Care Hospital
- Columbia, TN
- NPI 1861479545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1790748994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 NASHVILLE HWY",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "38401",
"telephone_number": "931-388-8965",
"fax_number": "931-388-0815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 NASHVILLE HWY",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "38401",
"telephone_number": "931-388-8965",
"fax_number": "931-388-0815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHALAK",
"first_name": "HEATHER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-10",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "238606",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD44004",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1511458",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.