Heather R Tonello, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601004123 Issued in MI

Practice address

9249 W Lake City Rd
Houghton Lake, MI 48629-9602

Phone

(989) 422-5122

Fax

(989) 422-4378

NPI assigned

Dec 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heather R Przybylo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1871579466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9249 W LAKE CITY RD",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299602",
            "telephone_number": "989-422-5122",
            "fax_number": "989-422-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9249 W LAKE CITY RD",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299602",
            "telephone_number": "989-422-5122",
            "fax_number": "989-422-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONELLO",
        "first_name": "HEATHER",
        "middle_name": "R",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "PRZYBYLO",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• TDS Pharmacy, Inc. (Sheldon Medical Supply)
• Teter Orthotics & Prosthetics, Inc
• Trevin Joseph Tharp, FNP-C
• Timothy C St. John II (Houghton Lake Foot Clinic)
• Hetty Toms, PT
• Township of Markey
• Melissa K Trout, LMSW
• Unity Home Care Services, LLC
• Mary Anne Vanoosterhout, M.S., R.D., CDE
• Robert J Vanoosterhout, MA,LLP,CSW

• Medical Physician Assistant in Houghton Lake, MI
• Providers in Houghton Lake, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.