NPIMap

Individual provider Active NPI

Mary Heady, D.O.

  • Family Medicine Physician
  • Port Orchard, WA
National Provider Identifier
1811351752
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60947864 Issued in WA
Practice address
450 S Kitsap Blvd Ste 210
Port Orchard, WA 98366-3738
Phone
(360) 874-5900
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60947864 WA Primary

Addresses

Primary practice location

450 S Kitsap Blvd Ste 210
Port Orchard, WA 98366-3738

Mailing address

450 S Kitsap Blvd Ste 210
Port Orchard, WA 98366-3738
Phone (360) 874-5900

Other identifiers 1

IdentifierTypeStateIssuer
2138624MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mheady512028@fhsce.catholichealth.net Direct
Direct Messaging Address mheady512028@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191113002695 WA Practitioner - Family Practice 8628342359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

450 S Kitsap Blvd
Suite 210
Port Orchard, WA 98366-3738
Phone (360) 874-5900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
15790CAMDMental Health Counselor
OP60947864WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 10, 2019 Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Sep 10, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients

Locations

450 S Kitsap Blvd
Ste 210
Port Orchard, WA 98366
Phone (360) 874-5900

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: mheady512028@fhsce.catholichealth.net

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1811351752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 210",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-874-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 210",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-874-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADY",
        "first_name": "MARY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60947864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138624",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mheady512028@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "450 S Kitsap Blvd Ste 210",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mheady512028@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "450 S Kitsap Blvd Ste 210",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.