Individual provider Active NPI

Heather Mae Demaree, P.A.C.

  • Medical Physician Assistant
  • Jellico, TN
National Provider Identifier
1972930204
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2306 Issued in TN
Practice address
131 Hospital LN
Jellico, TN 37762-4404
Phone
(423) 784-7269
Fax
(423) 784-3708
NPI assigned
Oct 1, 2013
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2306 TN Primary

Addresses

Primary practice location

131 Hospital LN
Jellico, TN 37762-4404

Mailing address

PO Box 447
Jellico, TN 37762-0447
Phone (423) 784-7269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140804001986 TN Practitioner - Physician Assistant 9133346877 Reassigns benefits to 1 organization
I20221108001346 KY Practitioner - Physician Assistant 9133346877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles H. Wilkens, M.D.,P.C.Group PAC ID 8224073432, 3 clinicians

Practice addresses (Care Compare)

131 Hospital LN
Jellico, TN 37762-4404
Phone (423) 784-7269

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2306TNMDAudiologist

Interoperability endpoints

  • Direct secure messaging: hdemaree@chw03.gwaydirect.com
  • Direct secure messaging: heather.demaree.1@24026.direct.athenahealth.com
  • Direct secure messaging: heather.demaree.1@24159.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1972930204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377620447",
            "telephone_number": "423-784-7269",
            "fax_number": "423-784-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624404",
            "telephone_number": "423-784-7269",
            "fax_number": "423-784-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAREE",
        "first_name": "HEATHER",
        "middle_name": "MAE",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jellico, TN

Sources for this page

Verify at the official NPI Registry.