Individual provider Active NPI

Caroline Kiteley Heideman, DO

  • Internal Medicine Physician
  • Lansing, MI
National Provider Identifier
1891229100
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101023401 Issued in MI
Practice address
401 W Greenlawn Ave
Lansing, MI 48910-2819
Phone
(517) 975-6000
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101023401 MI Primary

Addresses

Primary practice location

401 W Greenlawn Ave
Lansing, MI 48910-2819

Mailing address

401 W Greenlawn Ave
Lansing, MI 48910-2819

Other names 1

  • Caroline Kiteley Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230831003996 AL Practitioner - Medical Oncology 0345603791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2501 Village Professional Dr
Opelika, AL 36801-2381
Phone (334) 528-1070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
78.94
Promoting interoperability
100
Improvement activities
40
Cost
72.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023401MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The East Alabama Health Care Authority CurrentSince Sep 1, 2023 Accepting new patients
The East Alabama Health Care Authority CurrentSince Sep 1, 2023 Accepting new patients
Emergency Medicine South Past Accepting new patients

Locations

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

2501 Village Professional Dr
Opelika, AL 36801
Phone (334) 528-1070

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/c5013bf3-ebba-4bda-8574-ed83da9e1633/

Organizations & group practices 3

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 2

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1891229100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102819",
            "telephone_number": "517-975-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEMAN",
        "first_name": "CAROLINE",
        "middle_name": "KITELEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101023401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "KITELEY",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.