Individual provider Active NPI

Lindsay Nicole Heilman, PA-C

  • Medical Physician Assistant
  • Gainesville, FL
National Provider Identifier
1841508454
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109457 Issued in FL
Practice address
6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308
Phone
(352) 332-3900
Fax
(352) 332-5009
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109457 FL Primary

Addresses

Primary practice location

6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308

Mailing address

4371 Veronica S Shoemaker Blvd
Attn Credentialing
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
111100100MedicaidFL

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109457FLMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1841508454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "address_2": "ATTN CREDENTIALING",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 W NEWBERRY RD",
            "address_2": "EAST WING, SUITE 100",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054308",
            "telephone_number": "352-332-3900",
            "fax_number": "352-332-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "LINDSAY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111100100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.