Heather Naomi Champney, M.D.
Individual provider Active NPI Pediatrics Physician · Elizabethton, TN
NPI 1912174657 · NPPES record last updated Aug 15, 2016
Key facts
- NPI
- 1912174657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD0000044805 (TN)
- Practice address
- 117 E F St
Elizabethton, TN 37643-3253 - Phone
- (423) 547-9355
- Fax
- (423) 547-9356
- NPI assigned
- May 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090714000799 | TN | Practitioner - Pediatric Medicine |
9830241355 | Reassigns benefits to 2 organizations |
| I20250409001095 | VA | Practitioner - Hospitalist |
9830241355 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000044805 | TN | MD | Pediatrics Physician |
| MD44805 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Education Assistance Corporation | Pediatrics | Current |
Accepting new patients |
| Tri-Cities Regional Emergency Physicians, PC | Emergency Medicine | Current |
Accepting new patients |
| Mountain States Health Alliance | Past | Accepting new patients | |
| Johnson City Emergency Physicians, PC | Emergency Medicine | Past | Accepting new patients |
| Mountain States Health Alliance | Past | Accepting new patients | |
| Mountain States Health Alliance | Past | Accepting new patients |
Locations
1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300
325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280
400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 44805 | TN | |
| Pediatrics Physician | 208000000X | MD0000044805 | TN | Yes |
| Pediatrics Physician | 208000000X | MD44805 | TN |
Addresses
Primary practice location
117 E F St
Elizabethton, TN 37643-3253
Mailing address
117 E F St
Elizabethton, TN 37643-3253
Phone (423) 547-9355
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1514066 | Medicaid | TN | |
| 1912174657 | Medicaid | VA |
Other providers in Elizabethton, TN
- Eric Andrew Carter
- Erica Renee Carter
- Glenna Cates
- Scott O Caudle
- Champion Physical Therapy LLC Halls
- Christopher Manoli Chrisohon
- Vivian M Clark
- Buddy J Clayton
- Brandon Cole
- Joshua Cole
All providers in Elizabethton, TN · Pediatrics Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.