Jacob Mitchell Heath

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14367 Issued in NC

Practice address

120 Health Center Dr
Ahoskie, NC 27910-8161

Phone

(252) 287-0814

NPI assigned

Apr 2, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Roanoke Chowan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Colerain, NC
  • NPI 1790851004
  Medicare reassignment NPD
• Roanoke Chowan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Woodland, NC
  • NPI 1023675113
  NPD
• Roanoke Chowan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ahoskie, NC
  • NPI 1407881691
  NPD

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1801690490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-287-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "JACOB",
        "middle_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad E Hauser, O.D.
• Deja Jahmi Hawkins
• Health Services Personnel
• Healthcare Resources Group LLC
• Gerwyn Evans Heath, LPA
• Jorge Enrique Hernandez, M.D.
• Hertford County Public Health Authority
• Hertford County Public Health Authority
• Hertford County Public Health Authority
• Hertford Place, LLC

• General Practice Dentistry in Ahoskie, NC
• Providers in Ahoskie, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.