Active NPI
Andrea M. Heaton, APN
- Pediatric Nurse Practitioner
- Greeneville, TN
National Provider Identifier
1891962486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APN0000013220
- Practice address
- 428 E Vann Rd
Greeneville, TN 37743-7202 - Phone
- (423) 278-1950
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- No
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.
-
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
TN
-
- Internal Medicine Physician
- Johnson City, TN
- NPI 1053762112
-
- Family Medicine Physician
- Johnson City, TN
- NPI 1982553756
-
- Cardiovascular Disease Physician
- Johnson City, TN
- NPI 1740227131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171025001913 | TN | Practitioner - Nurse Practitioner | 7517233240 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000013220 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Past | Accepting new patients |
Locations
1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380
428 E Vann Rd
Greeneville, TN 37743
Phone (423) 278-1950
2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867
1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APN0000013220 | TN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
428 E Vann Rd
Greeneville, TN 37743-7202
Mailing address
PO Box 15004
Knoxville, TN 37901
Phone (865) 522-9730
Other identifiers 2
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4188703 | Other | TN | BCBS |
| 1510583 | Medicaid | TN |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 21, 2014.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390262400000",
"number": "1891962486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15004",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37901",
"telephone_number": "865-522-9730",
"fax_number": "865-637-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 E VANN RD",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377437202",
"telephone_number": "423-278-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATON",
"first_name": "ANDREA",
"middle_name": "M.",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2014-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TN",
"license": "APN0000013220",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4188703",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1510583",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.