Malcolm John Heagle II, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME82111 Issued in FL

Practice address

10000 Bay Pines BVLD
St Petersburg, FL 33744

Phone

(727) 398-6661

NPI assigned

Oct 13, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bayfront Enterprises Inc

  • Urgent Care Clinic/Center
  • St Petersburg, FL
  • NPI 1710963236
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972693422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TOLEDO WAY NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043835",
            "telephone_number": "727-742-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BVLD",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAGLE",
        "first_name": "MALCOLM",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME82111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacinda Lee Moyer Hays, D.O.
• Lorissa Hayth, M.S. CCC-SLP
• HCA
• Bryane Heaberlin
• Elwood J Headley, M.D.
• Heal Precisely of Northside LLC
• Heal Precisely of Tampa Bay LLC
• Jennylyn Bagaoisan Healey
• Healing Center LLC
• Healmi Technologies, LLC

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.