Active NPI
Eric J. Heathers, M.D.
- Family Medicine Physician
- Kokomo, IN
National Provider Identifier
1972541126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01044350A
- Practice address
- 3508 S Lafountain St
Kokomo, IN 46902-3803 - Phone
- (765) 864-5704
- Fax
- (765) 864-5720
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01044350A | IN | Primary |
Addresses
Primary practice location
3508 S Lafountain St
Kokomo, IN 46902-3803
Mailing address
3508 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 864-5704
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562454401 | Other | IN | SAGAMORE |
| 562454401 | Other | IN | M PLAN |
| 562454401 | Other | IN | AETNA |
| 562454401 | Other | IN | UNITED HEALTHCARE |
| 562454401 | Other | IN | TRICARE |
| 562454401 | Other | IN | ADVANTAGE HEALTHCARE |
| P00141244 | Other | IN | R.R. MEDICARE |
| 562454401 | Other | IN | WASAU |
| 000000342682 | Other | IN | BLUE CROSS BLUE SHIELD |
| 200062130A | Medicaid | IN | |
| 562454401 | Other | IN | ENCORE |
| 562454401 | Other | IN | CIGNA |
| 562454401 | Other | IN | HUMANA |
| 562454401 | Other | IN | SUBURBAN HEALTH |
| 562454401 | Other | IN | AARP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1972541126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3508 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023803",
"telephone_number": "765-864-5704",
"fax_number": "765-864-5720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3508 S LAFOUNTAIN ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023803",
"telephone_number": "765-864-5704",
"fax_number": "765-864-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATHERS",
"first_name": "ERIC",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01044350A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAGAMORE",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M PLAN",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVANTAGE HEALTHCARE",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R.R. MEDICARE",
"identifier": "P00141244",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASAU",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000342682",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200062130A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ENCORE",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBURBAN HEALTH",
"identifier": "562454401",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AARP",
"identifier": "562454401",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.