NPIMap

Individual provider Active NPI

Reandy Nicole Hearn

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1922563667
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08706 Issued in NC
Practice address
2911 Breezewood Ave Ste 100
Fayetteville, NC 28303-5464
Phone
(910) 824-7619
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08706 NC Primary

Addresses

Primary practice location

2911 Breezewood Ave Ste 100
Fayetteville, NC 28303-5464

Mailing address

2911 Breezewood Ave Ste 100
Fayetteville, NC 28303-5464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190318002195 NC Practitioner - Physician Assistant 1557601143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prana Health PLLCGroup PAC ID 0143519264, 4 clinicians

Practice addresses (Care Compare)

1212 Central Dr
Suite 103
Sanford, NC 27330-4170
Phone (919) 935-0773

200 Forsythe St
Fayetteville, NC 28303-5426
Phone (910) 824-7619

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prana Health PLLC CurrentSince Feb 15, 2019 Accepting new patients

Locations

200 Forsythe St
Fayetteville, NC 28303
Phone (910) 485-0700

2911 Breezewood Ave
Ste 100
Fayetteville, NC 28303
Phone (910) 485-4101

1212 Central Dr
Ste 103
Sanford, NC 27330
Phone (910) 824-7619

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1922563667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 BREEZEWOOD AVE STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 BREEZEWOOD AVE STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035464",
            "telephone_number": "910-824-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "REANDY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.