Heavens Medical Plc | |
105 S Delaware Dr Ste 2 Apache Jct AZ 85120-6512 | |
(480) 646-1001 | |
Not Available |
Full Name | Heavens Medical Plc |
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Speciality | Clinic/Center |
Location | 105 S Delaware Dr Ste 2, Apache Jct, Arizona |
Authorized Official Name and Position | Jason Heavens (PRESIDENT) |
Authorized Official Contact | 4803996440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Heavens Medical Plc 105 S Delaware Dr Ste 1 Apache Junction AZ 85120-6512 Ph: (480) 646-1001 | Heavens Medical Plc 105 S Delaware Dr Ste 2 Apache Jct AZ 85120-6512 Ph: (480) 646-1001 |
NPI Number | 1023381555 |
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Provider Enumeration Date | 02/14/2012 |
Last Update Date | 02/15/2021 |
Medicare PECOS PAC ID | 5395991822 |
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Medicare Enrollment ID | O20120815000659 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023381555 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Provider Name | Jason P Heavens |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063781797 PECOS PAC ID: 3375799810 Enrollment ID: I20120815000744 |
Provider Name | Melinda Marie Ramsdell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174995807 PECOS PAC ID: 0547567042 Enrollment ID: I20160329000996 |
Provider Name | Noah Kipkorir Sang |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457839896 PECOS PAC ID: 1153674999 Enrollment ID: I20181025000561 |
Provider Name | Dusty Elaine Pickering |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659854321 PECOS PAC ID: 9436498722 Enrollment ID: I20190304002759 |
Provider Name | Alexander L Dupuis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528537750 PECOS PAC ID: 1153661392 Enrollment ID: I20190325002768 |
Provider Name | Lorna Millbourn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952740789 PECOS PAC ID: 6002058203 Enrollment ID: I20190716001376 |
Provider Name | Abigail Lee Moreno |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306491113 PECOS PAC ID: 0345571725 Enrollment ID: I20191016002004 |
Provider Name | Shana J Bean |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538709761 PECOS PAC ID: 7214363290 Enrollment ID: I20200211001702 |
Provider Name | Linda Mcphail |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487192142 PECOS PAC ID: 3577836568 Enrollment ID: I20200420002894 |
Provider Name | Jamie Linnea Richardson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487257093 PECOS PAC ID: 2264843069 Enrollment ID: I20201130003126 |
Provider Name | Steven Gregory Gonos |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932789989 PECOS PAC ID: 2466860770 Enrollment ID: I20210426000788 |