JAMES K HEACOCK MD LLC (NPI# 1235296393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235296393 |
| Entity Type | Organization |
| Organization Name | JAMES K HEACOCK MD LLC |
| Practice Address |
1640 Route 88 Suite 203 Brick NJ 08724-3036 |
| Practice Telephone | 7324587777 |
| Practice Fax Number | 7324586741 |
| Mailing Telephone | 7324587777 |
| Mailing Fax Number | 7324586741 |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAMES KIPP HEACOCK (OWNER) |
| Authorized Official Telephone | 7324587777 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
MA 34928 | NJ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 4745809 | 05 |
| Street Address |
1640 ROUTE 88 SUITE 203 |
| City | BRICK |
| State | NJ |
| Zip Code | 08724-3036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164420667 | Meridian Hospitals Corporation | General Acute Care Hospital | 1640 Route 88, Brick Medical Arts Building Suite 102, Brick, NJ 08724-3036 | 2005-07-08 |
| 1003275322 | Fresenius Medical Care Ocean, LLC | Clinic/Center | 1640 Route 88, Suite 102, Brick, NJ 08724-3068 | 2016-02-15 |
| 1235543505 | Optimal Medical Associates LLC | Clinic/Center | 1640 Route 88, Suite 203, Brick, NJ 08724-3068 | 2014-06-16 |
| 1073948337 | Alexis Jaskowski | Physical Therapist | 1640 Route 88, Brick, NJ 08724-3068 | 2013-09-05 |
| 1437341526 | Owen Carolan Md LLC | Family Medicine | 1640 Route 88, Suite 203, Brick, NJ 08724-3068 | 2007-08-13 |
| 1134310667 | Owen Joseph Carolan | Family Medicine | 1640 Route 88, Suite 203, Brick, NJ 08724-3068 | 2007-08-08 |
| 1720131469 | Jarahian Medical LLC | Internal Medicine | 1640 Route 88, Suite 203, Brick, NJ 08724-3036 | 2007-01-18 |
| 1649327602 | Shore Cardiology Consultants LLC | Internal Medicine | 1640 Route 88, Suite 201, Brick, NJ 08724-3036 | 2007-01-04 |
| 1891859484 | Brick Rheumatology, LLC | Internal Medicine | 1640 Route 88, Suite 203, Brick, NJ 08724-3036 | 2006-12-20 |
| 1578635512 | Christine L Fuschetto | Physical Therapist | 1640 Route 88, Brick, NJ 08724-3036 | 2006-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386498 | Mark Malak | Pharmacist | 668 New Jersey Ave # 70, Brick, NJ 08724 | 2020-11-08 |
| 1699381681 | Kimberly Granai | Nurse Practitioner | 1617 Nj-88, Brick Township, NJ 08724 | 2020-09-16 |
| 1407461346 | Marina N Samuel | Pharmacist | 1890 Rt 88, Brick, NJ 08724 | 2020-09-08 |
| 1255974440 | Diana Rachel Williamson | Pharmacy Technician | 1610 Rt. 88 West, Suite 103, Brick, NJ 08724 | 2019-10-21 |
| 1710536842 | Stephanie Ann Papa | Nurse Practitioner | 2125 Nj 88, Brick, NJ 08724 | 2019-09-11 |
| 1417504515 | Susan B Anthony | Physical Therapist | 676 Overlook Ct, Brick, NJ 08724 | 2019-08-22 |
| 1831688076 | Jennifer S Cashin | Social Worker | 1500 Nj-88, Brick, NJ 08724 | 2018-05-03 |
| 1528555315 | James Kish Pt | Physical Therapist | 602 Yellowbrick Rd, Brick, NJ 08724 | 2018-04-17 |
| 1396262200 | Michael Stephen Zito-govert | Nurse Practitioner | 1640 Route 88 West, Suite 203, Brick, NJ 08724 | 2017-08-23 |
| 1083140420 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Route 70 East, Brick, NJ 08724 | 2017-05-04 |
| Find all providers in zip 08724 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720479769 | Advanced Medical Weight Loss and Esthetics | Clinic/Center | 1631 Route 88 W, Suite A, Brick, NJ 08724-3048 | 2015-02-12 |
| 1528380292 | Hands On Health Chiropractic, LLC | Clinic/Center | 321 Mantoloking Rd, Brick, NJ 08723-5741 | 2010-02-23 |
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| 1265059224 | Rhemacare Medicals | Clinic/Center | 1992 Morris Ave # 215, Union, NJ 07083-3507 | 2020-06-25 |
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| 1558982439 | Omegahealth LLC | Clinic/Center | 90 E Halsey Rd Ste 333, Parsippany, NJ 07054-3709 | 2020-05-01 |
| 1588298962 | Gen-tel Medicine, LLC | Clinic/Center | The Center for Prevention and Counseling/dr.ganon, 61 Spring Street, First Floor, Newton, NJ 07860 | 2020-02-25 |
| 1134760754 | Medisure Inc. | Clinic/Center | 2310 Inverness Dr, Toms River, NJ 08753-6313 | 2019-10-04 |
| 1477012698 | Health and Integrative Wellness LLC | Clinic/Center | 59 E Mill Rd Ste 201-1, Long Valley, NJ 07853-6215 | 2019-03-18 |
| 1093289852 | Idama Healthcare | Clinic/Center | 4 S Orange Ave Suite 253, South Orange, NJ 07079-1702 | 2019-01-15 |
| 1992278709 | Dr David Bee and Associates LLC | Clinic/Center | 1304 Route 47 Unit M, Rio Grande, NJ 08242-1399 | 2019-01-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.