Active NPI
Heath O'Bryan Shealy, LAC
- Acupuncturist
- Tucson, AZ
National Provider Identifier
1790977940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- LAC-012167
- Practice address
- 6502 E Carondelet Dr
Tucson, AZ 85710-2117 - Phone
- (520) 505-1990
- NPI assigned
- Aug 13, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Acupuncturist | 171100000X | LAC-012167 | AZ | Primary |
Addresses
Primary practice location
6502 E Carondelet Dr
Tucson, AZ 85710-2117
Mailing address
6502 E Carondelet Dr
Tucson, AZ 85710-2117
Phone (520) 488-8741
Other practice location 1
3809 Rosewood Dr
Columbia, SC 29205-3533
Phone (803) 786-1844
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-012167 | AZ | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chill Acupuncture and Wellness LLC | Acupuncturist | Current | Accepting new patients |
| Mental Illness Recovery Center | Past | Accepting new patients |
Locations
6502 E Carondelet Dr
Tucson, AZ 85710
Phone (520) 290-9651
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/7878c7ba-d1a3-4bd2-9b45-7234d7142c12/
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.
-
- Acupuncturist
- Tucson, AZ
- NPI 1346023215
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1194047563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1790977940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6502 E CARONDELET DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857102117",
"telephone_number": "520-488-8741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6502 E CARONDELET DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857102117",
"telephone_number": "520-505-1990"
}
],
"practiceLocations": [
{
"address_1": "3809 Rosewood Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292053533",
"country_code": "US",
"telephone_number": "803-786-1844",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEALY",
"first_name": "HEATH",
"middle_name": "O'BRYAN",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-13",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "AZ",
"license": "LAC-012167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.