DR. KELLY HEEGARD (NPI# 1538397807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538397807 |
| Entity Type | Individual |
| Full Name | DR. KELLY HEEGARD |
| Credential | M.D. |
| Practice Address |
203 Mills Ave Greenville SC 29605-4019 |
| Practice Telephone | 8642711844 |
| Practice Fax Number | 8642712147 |
| Mailing Telephone | 8642711844 |
| Mailing Fax Number | 8642712147 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
52383 | SC | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
ME131121 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SC MEDICAL LICENSE | 52383 | 01 |
| SC | 523838 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4583 Watkins St, Pace, FL 325712511 | 8508894152 | 8506233938 |
| 4304 Lancaster Dr, Niceville, FL 325784563 | 8508622385 | 8508620482 |
| 8880 Navarre Pkwy Ste 101, Navarre, FL 325663613 | 8508622385 | 8508620482 |
| 14114 Alabama St, Jay, FL 325651219 | 8504444700 | 8504348144 |
| 1118 Gulf Breeze Pkwy Ste 200, Gulf Breeze, FL 325617806 | 8504444700 | 8504348144 |
| 319 Green Acres Rd Ste 103, Fort Walton Beach, FL 325471170 | 8508622385 | 8508620482 |
| 36474a Emerald Coast Pkwy Ste 1102, Destin, FL 325413706 | 8508622385 | 8508620482 |
| 4415 Us Highway 331 S, Defuniak Springs, FL 324356307 | 8503986606 | 8503986424 |
| 221 E Redstone Ave, Crestview, FL 325395373 | 8503986606 | 8503986424 |
| 6001 Industrial Blvd, Century, FL 325353312 | 8504444700 | 8504348144 |
| 2940 N Blue Angel Pkwy, Pensacola, FL 325062925 | 8504444700 | 8504348144 |
| 307 Boatner Rd, Ste 114, Eglin Afb, FL 325421302 | 8508838132 | |
| 5934 Berryhill Medical Park Dr # 1, Milton, FL 32570 | 8506234771 | 8506233938 |
| 1619 Creighton Rd Ste 1, Pensacola, FL 32504 | 8504444700 | 8504348144 |
| 121 Commerce Blvd Ste B, Easley, SC 296421544 | 8648593038 | 8642712147 |
| Street Address |
203 MILLS AVE |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881689966 | Kaye R Christopher | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2005-09-15 |
| 1275179681 | Lori Nichole Huang | Dietitian, Registered | 203 Mills Ave, Greenville, SC 29605-4019 | 2019-11-20 |
| 1427545854 | Dejan Lukovic | Nurse Practitioner | 203 Mills Ave, Greenville, SC 29605-4019 | 2018-04-20 |
| 1336532456 | John Francis Sharkey Iv | Nurse Practitioner | 203 Mills Ave, Greenville, SC 29605-4019 | 2015-03-13 |
| 1841618329 | Tarak Shah | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2014-04-02 |
| 1235576372 | Brittani Ledford Robinson | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2013-05-30 |
| 1881823276 | Barry R. Gorlitsky | Internal Medicine | 203 Mills Ave, Carolina Nephrology, Pa, Greenville, SC 29605-4019 | 2009-07-07 |
| 1235371766 | Cynthia R Evans | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2009-03-30 |
| 1376794727 | Abhaya Varma | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2008-10-03 |
| 1013119288 | Chitra Nathan | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2007-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992276851 | Delta Kidney Alliance LLC | Internal Medicine | 1997 N Medical Park Dr, Greenville, MS 38703-7268 | 2018-12-17 |
| 1124188347 | Wilson M Parry | Internal Medicine | 1997 Medical Park Dr Ste A, Greenville, MS 38703-7268 | 2006-12-11 |
| 1033142724 | Nouhad O Kronfol | Internal Medicine | 1997 Medical Park Dr, Greenville, MS 38703-7268 | 2006-07-08 |
| 1538146303 | Joachim E Hertel | Internal Medicine | 10 Memorial Medical Dr, Greenville, SC 29605-4450 | 2005-12-22 |
| 1679557516 | Carolina Nephrology Pa | Internal Medicine | 203 Mills Avenue, Greenville, SC 29605-4019 | 2005-12-05 |
| 1881689966 | Kaye R Christopher | Internal Medicine | 203 Mills Ave, Greenville, SC 29605-4019 | 2005-09-15 |
| 1376540724 | Paul Bolin Jr. | Internal Medicine | 2355 W Arlington Blvd, Ecu Physicians Nephrology/hypertension Clinic, Greenville, NC 27834-2847 | 2005-06-30 |
| 1174525315 | Graham Vance Byrum Jr. | Internal Medicine | 511 Paladin Dr, Greenville, NC 27834-7826 | 2005-06-01 |
| 1710371091 | Anthony Provenzano | Internal Medicine | 511 Paladin Dr, Greenville, NC 27834-7826 | 2015-03-24 |
| 1780003624 | William Alfredo Davila | Internal Medicine | 2355 W Arlington Blvd, Ecu Physicians Nephrology and Hypertension, Greenville, NC 27834-2847 | 2014-04-08 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
Please comment or provide details below to improve the information on DR. KELLY HEEGARD.
| 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.