Individual provider Active NPI

Venessa Lorraine Heath, PA-C

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1962918946
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110903 Issued in FL
Practice address
2000 W Marine View Dr BLDG 2010
Everett, WA 98207-6985
Phone
(425) 304-4162
NPI assigned
Dec 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 PA9110903 FL Primary

Addresses

Primary practice location

2000 W Marine View Dr BLDG 2010
Everett, WA 98207-6985

Mailing address

2000 W Marine View Dr BLDG 2010
Everett, WA 98207-5000
Phone (425) 304-4162

Other practice location 1

12375 S Cleveland Ave
Fort Myers, FL 33907-3803
Phone (239) 936-2013

Other practice location 2

1708 Cape Coral Pkwy W
Cape Coral, FL 33914-6985
Phone (239) 333-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20180228001350 FL Practitioner - Physician Assistant 1355602780 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110903FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince May 1, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince May 1, 2022 Accepting new patients

Locations

1708 Cape Coral Pkwy W
Cape Coral, FL 33914
Phone (239) 333-3333

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

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.

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1962918946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W MARINE VIEW DR BLDG 2010",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982075000",
            "telephone_number": "425-304-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W MARINE VIEW DR BLDG 2010",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982076985",
            "telephone_number": "425-304-4162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12375 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339073803",
            "country_code": "US",
            "telephone_number": "239-936-2013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 Cape Coral Pkwy W",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339146985",
            "country_code": "US",
            "telephone_number": "239-333-3333",
            "fax_number": "239-333-3332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEATH",
        "first_name": "VENESSA",
        "middle_name": "LORRAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.