Active NPI
Jennifer Renee Heller, D.C.
- Chiropractor
- Brunswick, GA
National Provider Identifier
1962732669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR009588
- Practice address
- 208 Scranton Connector Ste 120
Brunswick, GA 31525-0561 - Phone
- (912) 264-2244
- Fax
- (404) 855-4381
- NPI assigned
- Jan 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2009039698 | MO | |
| Chiropractor | 111N00000X | CHIR009588 | GA | Primary |
Addresses
Primary practice location
208 Scranton Connector Ste 120
Brunswick, GA 31525-0561
Mailing address
208 Scranton Connector Ste 120
Brunswick, GA 31525-0561
Phone (912) 264-2244
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EA2937 | Other | MEDICARE RRB | |
| P02546258 | Other | MEDICARE RRB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
208 Scranton Connector
Suite 120
Brunswick, GA 31525-0561
Phone (912) 264-2244
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR009588 | GA | MD | Chiropractor |
| 2009039698 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brunswick Urgent Care, LLC | Current | Accepting new patients | |
| Heller Family Medicine, LLC | Past | Accepting new patients |
Locations
208 Scranton Connector
Ste 120
Brunswick, GA 31525
Phone (912) 264-2244
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.
-
- Chiropractor
- Brunswick, GA
- NPI 1346571148
-
- Family Nurse Practitioner
- Brunswick, GA
- NPI 1023571411
-
- Nurse Practitioner
- Brunswick, GA
- NPI 1831545508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1962732669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 SCRANTON CONNECTOR STE 120",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315250561",
"telephone_number": "912-264-2244",
"fax_number": "404-855-4381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 SCRANTON CONNECTOR STE 120",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315250561",
"telephone_number": "912-264-2244",
"fax_number": "404-855-4381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLER",
"first_name": "JENNIFER",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-04",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2009039698",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR009588",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RRB",
"identifier": "EA2937",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RRB",
"identifier": "P02546258",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.