Walter Lewis Heatherly

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9019 Overlook Blvd Ste C1B
Brentwood, TN 37027-2737

Phone

(615) 274-9767

NPI assigned

Jan 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Florida International Univ, College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Nashville, TN, CCN 447206

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: walter.heatherly.1@30029.direct.athenahealth.com

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.

• Iris Medical Group

  • Primary Care Clinic/Center
  • Brentwood, TN
  • NPI 1851025902
  Medicare reassignment Care Compare group
• Iris Wound Care, PC

  • Clinic/Center
  • Brentwood, TN
  • NPI 1568273605
  Medicare reassignment
• Iris Medical Group Kentucky LLC

  • Primary Care Clinic/Center
  • Bowling Green, KY
  • NPI 1336908110
  NPD (past)

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

• Comprehensive Home Healthcare Services LLC

  • Home Health Agency
  • Nashville, TN
  • NPI 1689622466
  Care Compare affiliation

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1962115873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9019 OVERLOOK BLVD STE C1B",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272737",
            "telephone_number": "615-274-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9019 OVERLOOK BLVD STE C1B",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272737",
            "telephone_number": "615-274-9767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Franklin Rd Ste 135-A270",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370273280",
            "country_code": "US",
            "telephone_number": "225-284-7336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEATHERLY",
        "first_name": "WALTER",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hearingplanet, LLC
• Matthew L Hearp, MD
• Heart of the Home Respite and Homemaker Care LLC
• Heartland Dental Care of Tennessee, PC
• Melissa R Heath
• Mikhail A Heber, M.D.
• Morgan Elyse Heber, MD
• Angela Hedman
• Jennifer J Heinrich, PA-C
• Henderson Counseling Services Inc

• Physician Assistant in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.