Active NPI
Nkayla Headen
- Ophthalmology Physician
- Dacula, GA
National Provider Identifier
1992570642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 100XXX
- Practice address
- 1184 Ivey Chase PL
Dacula, GA 30019-7868 - Phone
- (678) 256-4429
- NPI assigned
- Nov 21, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 100XXX | GA | Primary |
Addresses
Primary practice location
1184 Ivey Chase PL
Dacula, GA 30019-7868
Mailing address
1184 Ivey Chase PL
Dacula, GA 30019-7868
Phone (678) 256-4429
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100XXX | GA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1992570642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1184 IVEY CHASE PL",
"city": "DACULA",
"state": "GA",
"postal_code": "300197868",
"telephone_number": "678-256-4429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1184 IVEY CHASE PL",
"city": "DACULA",
"state": "GA",
"postal_code": "300197868",
"telephone_number": "678-256-4429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEADEN",
"first_name": "NKAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "GA",
"license": "100XXX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.