Colleen Kelly Heartsill, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

M4835 Issued in TX

Practice address

3501 Knickerbocker Rd
San Angelo, TX 76904-7610

Phone

(325) 949-9555

NPI assigned

May 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Colleen E Kelly Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

University of Texas Medical School at San Antonio, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score

82.63 of 100Reported as group

Quality

78.21

Promoting interoperability

96

Improvement activities

40

Cost

67.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Shannon Clinic

  dba Vista Verde Medical Plaza

  • Pediatrics Physician
  • Del Rio, TX
  • NPI 1790986719
  NPD

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

• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1982815130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046884",
            "telephone_number": "325-949-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-949-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARTSILL",
        "first_name": "COLLEEN",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-26",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M4835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "KELLY",
            "middle_name": "E",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Lynn Hayton, PA-C
• Jiahe He
• Healthcare Continuum, Inc.
• Healthy by Kelsey
• Hearinglife TX, LLC
• Lucas G. Heartsill, MD
• Tonya Heath
• Johnny Lee Hedges, AG-ACNP-BC
• Erika Anne Heffner, PHARMD, MBA
• Roland Heidenhofer, M.D.

• Anesthesiology Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.