Healthcare Provider Details

I. General information

NPI: 1942929849
Provider Name (Legal Business Name): JAMES HEATON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE STE 400A
CINCINNATI OH
45220-3027
US

IV. Provider business mailing address

3219 CLIFTON AVE STE 400A
CINCINNATI OH
45220-3027
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax: 513-861-5267
Mailing address:
  • Phone: 513-246-2400
  • Fax: 513-861-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number50.007720RX
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.007720RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: