Active NPI
Nathan Kyle Heady, PA-C
- Physician Assistant
- Carrier Mills, IL
National Provider Identifier
1861901530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085006959
- Practice address
- 7211 US 45 S
Carrier Mills, IL 62917-1305 - Phone
- (833) 209-0498
- Fax
- (618) 724-4628
- NPI assigned
- Sep 26, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TC654 | KY | |
| Physician Assistant | 363A00000X | 085006959 | IL | Primary |
Addresses
Primary practice location
7211 US 45 S
Carrier Mills, IL 62917-1305
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1861901530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 155",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "628220155",
"telephone_number": "618-724-2401",
"fax_number": "618-724-4628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7211 US 45 S",
"city": "CARRIER MILLS",
"state": "IL",
"postal_code": "629171305",
"telephone_number": "833-209-0498",
"fax_number": "618-724-4628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEADY",
"first_name": "NATHAN",
"middle_name": "KYLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-26",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "TC654",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrier Mills, IL
- Carrier Mills Nursing & Rehabilitation Center, LLC
- Carrier Mills-Stonefort Community Unit Dist 2
- Christopher Greater Area Rural Health Planning Corporation
- Sarah Fogle
- Harrisburg Family Practice LTD
- Kelley M Mitchell X, LPN
- Jennifer Elaine Price, PA-C
- Nikki Reed, M.S. SLP-CCC
- Stacy Lynn Sumner
- Katrina L Tripp, PAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.