MICHAEL R HEAPHY JR.
MOUNTAIN WEST DERM - BLACKHART PLLC

Address: 640 W Moana Ln, Reno, NV 89509-4903
Telephone: 7753240699

MICHAEL R HEAPHY JR. is a physician enrolled with Centers for Medicare & Medicaid Services (CMS). The enrollment date is April 13, 2018.

Physician Overview

MICHAEL R HEAPHY JR. is a dermatology enrolled with Centers for Medicare & Medicaid Services (CMS). The organization name is MOUNTAIN WEST DERM - BLACKHART PLLC. The business address is 640 W Moana Ln, Reno, NV 89509-4903.

Enrollment Information

NPI 1174620496 Nation Provider Identifier (NPI)
National Plan and Provider Enumeration System (NPPES)
PAC ID 7416977582 PECOS Associate Control (PAC) ID
Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20180413001324
Full Name MICHAEL R HEAPHY JR.
Gender M
Credential MD - Medical Doctor
Medical School UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year 1999
Primary Specialty DERMATOLOGY
Organization Legal Name MOUNTAIN WEST DERM - BLACKHART PLLC
Group Practice PAC ID 1153609813
Number of Group Practice Members 86
Address 640 W Moana Ln
Reno
NV 89509-4903
Telephone 7753240699
Professional Accepts Medicare Assignment Y - Accepts Medicare approved amount as payment in full
Group Accepts Medicare Assignment Y - Accepts Medicare approved amount as payment in full

Provider Overview

NPI 1174620496 Nation Provider Identifier (NPI)
National Plan and Provider Enumeration System (NPPES)
Provider Name MICHAEL RILEY HEAPHY JR.
Address 4814 Sparks Blvd
Sparks
NV 89436
Classification Dermatology - Dermatopathology
Taxonomy Code 207ND0900X
Enumeration Date 2006-09-20

Location Information

Organization Legal NameAddressTelephone
MOUNTAIN WEST DERM - BLACKHART PLLC1700 W Riverstone Dr, Coeur D Alene, ID 83814-56832087702822
MOUNTAIN WEST DERM - BLACKHART PLLC1807 N Hutchinson Rd, Spokane Valley, WA 99212-24445094567414
MOUNTAIN WEST DERM - BLACKHART PLLC3640 Warren Way, Reno, NV 89509-52407753240699
MOUNTAIN WEST DERM - BLACKHART PLLC3841 Piper St, Suite T4 020, Anchorage, AK 99508-46739076468500
MOUNTAIN WEST DERM - BLACKHART PLLC4513 Williams Dr, Georgetown, TX 78633-13025129303909
MOUNTAIN WEST DERM - BLACKHART PLLC5905 N Mayfair St, Suite 200, Spokane, WA 99208-11275094567414
MOUNTAIN WEST DERM - BLACKHART PLLC640 W Moana Ln, Reno, NV 89509-49037753240699
MOUNTAIN WEST DERM - BLACKHART PLLC7801 N Lamar Blvd, Suite D81 82, Austin, TX 78752-10165128683376

Extra Contact Information

AddressTelephoneGroup Practice PAC ID
3841 Piper St, Suite T4 020, Anchorage, AK 99508467390764685001153609813
1700 W Riverstone Dr, Coeur D Alene, ID 83814568320877028221153609813
640 W Moana Ln, Reno, NV 89509490377532406991153609813
3640 Warren Way, Reno, NV 89509524077532406991153609813
341 Nw Medical Loop, Suite 110, Roseburg, OR 97471554654144021651153609813
2747 Ne Conners Ave, Bend, OR 97701873854138257121153609813
4513 Williams Dr, Georgetown, TX 78633130251293039091153609813
7801 N Lamar Blvd, Suite D81 82, Austin, TX 78752101651286833761153609813
5905 N Mayfair St, Suite 200, Spokane, WA 99208112750945674141153609813
1807 N Hutchinson Rd, Spokane Valley, WA 99212-244450945674141153609813
1125 S 2nd Ave, Suite A, Walla Walla, WA 99362411850952594041153609813

Organization Information

Organization Legal Name MOUNTAIN WEST DERM - BLACKHART PLLC
Address 640 W Moana Ln
Reno
NV 89509-4903
Telephone 7753240699
Medical School UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON

Doctors with the same organization legal name

Doctor NamePrimary SpecialtyOrganization Legal NameAddress
Marla Kae Nmi Stahlnecker Nurse PractitionerMountain West Derm - Blackhart Pllc1125 S 2nd Ave, Suite A, Walla Walla, WA 99362-4118
Staci M Hestdalen DermatologyMountain West Derm - Blackhart Pllc5905 N Mayfair St, Suite 200, Spokane, WA 99208-1127
Alexandria Noel Staub Physician AssistantMountain West Derm - Blackhart Pllc2747 Ne Conners Ave, Bend, OR 97701-8738
Christopher R Jones Jr. DermatologyMountain West Derm - Blackhart Pllc4513 Williams Dr, Georgetown, TX 78633-1302
Tamara Lee Vandyke Physician AssistantMountain West Derm - Blackhart Pllc607 S Maine St, Fallon, NV 89406-3801
Doug Starley Physician AssistantMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903
Gretchen Korver DermatologyMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903
Mollie M Jan DermatologyMountain West Derm - Blackhart Pllc1309 Mormon Mill Rd, Marble Falls, TX 78654-4602
Michael John Housley Physician AssistantMountain West Derm - Blackhart Pllc7733 W Emerald St, Boise, ID 83704-9020
Andrea M Dominey DermatologyMountain West Derm - Blackhart Pllc1807 N Hutchinson Rd, Spokane Valley, WA 99212-2444
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Location Information

Street Address 640 W MOANA LN
City RENO
State NV
Zip Code 89509-4903

Doctors in the same location

Doctor NamePrimary SpecialtyOrganization Legal NameAddress
Doug Starley Physician AssistantMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903
Gretchen Korver DermatologyMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903
Sarah Elizabeth Gutierrez Physician AssistantMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903
Diane M Smith Nurse PractitionerMountain West Derm - Blackhart Pllc640 W Moana Ln, Reno, NV 89509-4903

Doctors in the same zip code

Doctor NamePrimary SpecialtyOrganization Legal NameAddress
Karyn Forsyth Psychologist, Clinical375 Caliente St, Reno, NV 89509-2729
Michael J Spevak Physical TherapySpevak Physical Therapy Nevada LLC3594 W Plumb Ln, Suite B, Reno, NV 89509-3087
Andrew P Drymalski Psychologist, Clinical3345 Thornhill Dr, Reno, NV 89509-3074
Joel Burg Clinical Social Worker505 S Arlington Ave, Suite 203, Reno, NV 89509-1525
Stephanie W Dillon Clinical Psychologist1065 Haskell St, Reno, NV 89509-2815
Colin B Chisholm Clinical Social Worker626 Humboldt St, Reno, NV 89509-1606
Sandie W Fox Clinical Social Worker505 S Arlington Ave, 212a, Reno, NV 89509-1527
John F Burgess Podiatry1225 Westfield Ave, Suite 2, Reno, NV 89509-1834
Christy Lighthouse OptometryEric R Kroll O D Ltd118 California Ave, Reno, NV 89509-1619
Matthew Boland Psychologist, ClinicalHealth Psychology Associates LLC245 Mount Rose St, Reno, NV 89509-3355
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Dataset Information

This dataset includes 1.5 million individual physicians, and other clinicians currently enrolled in Medicare. The dataset contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction United States