LARRY TRAVIS HEAP (NPI# 1366418113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366418113 |
| Entity Type | Individual |
| Full Name | LARRY TRAVIS HEAP |
| Credential | PA-C |
| Practice Address |
606 N Main St Eagar AZ 85925-9813 |
| Mailing Address |
Po Box 1610 Springerville AZ 85938-1610 |
| Practice Telephone | 9283335333 |
| Practice Fax Number | 9283335100 |
| Mailing Telephone | 9283335333 |
| Mailing Fax Number | 9283335100 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3048 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 933467 | 05 |
| Street Address |
606 N MAIN ST |
| City | EAGAR |
| State | AZ |
| Zip Code | 85925-9813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962407676 | Eileen T Furman | Nurse Practitioner | 606 N Main St, Eagar, AZ 85925-9813 | 2005-06-17 |
| 1558719468 | Ralph Adam Patterson | Family Medicine | 606 N Main St, Eagar, AZ 85925-9813 | 2016-06-01 |
| 1417338880 | James Heap | Family Medicine | 606 N Main St, Eagar, AZ 85925-9813 | 2015-06-11 |
| 1972802528 | Reece Kirby Hadlock | Physician Assistant | 606 N Main St, Eagar, AZ 85925-9813 | 2011-03-22 |
| 1790974830 | Scott R Hamblin Md, PC | Internal Medicine | 606 N Main St, Eagar, AZ 85925-9813 | 2007-10-15 |
| 1487609731 | Steven Shumway Hamblin | Specialist | 606 N Main St, Eagar, AZ 85925-9813 | 2006-05-24 |
| 1972594620 | Scott R Hamblin | Internal Medicine | 606 N Main St, Eagar, AZ 85925-9813 | 2005-11-02 |
| 1184615650 | Sean Patrick Wilson | Family Medicine | 606 N Main St, Eagar, AZ 85925-9813 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851950588 | Nicholas Talbert Mallory | Dentist | 133 W Central Ave, Eagar, AZ 85925 | 2019-06-06 |
| 1063945277 | Ez Counseling | Community/Behavioral Health | 910 S Burk St, Eagar, AZ 85925 | 2017-04-05 |
| 1114393782 | Mason Wade Trezise | Specialist/Technologist | 98 E 7th Pl, Eagar, AZ 85925 | 2015-08-18 |
| 1841673076 | Marshall Hunt Hamblin | Dentist | 133 West Central Ave., Eagar, AZ 85925 | 2015-07-07 |
| 1174895395 | Kevin M Eagar | Chiropractor | 41 W 2nd Ave, Eagar, AZ 85925 | 2012-02-03 |
| 1144465568 | Natalie Sue Cordova | Speech-Language Pathologist | 165 Brown Street, Eagar, AZ 85925 | 2008-12-15 |
| 1467500488 | Friendship House-rvccc | Assisted Living Facility | 381 E Third Ave, Eagar, AZ 85925 | 2007-01-08 |
| 1477611135 | Round Valley Unified School District #10 | Local Education Agency (LEA) | 165 S. Brown, Eagar, AZ 85925 | 2006-12-05 |
| 1316015712 | Brooke Arlene Mccarthy | Occupational Therapist | 352 North Renee Street, Eagar, AZ 85925 | 2006-12-01 |
| 1326003427 | Stephen M Palmer Dds PC | Dentist | 74 N Main St, Ste 9, Eagar, AZ 85925 | 2006-04-20 |
| Find all providers in zip 85925 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
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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.