NPI Code Detail JSON Logo

1225119399 NPI number — HEATHER MCCANN MCINTOSH M.D.

NPI Number: 1225119399
Health Care Provider/Practitioner: HEATHER MCCANN MCINTOSH M.D.

Information about “1225119399” NPI (HEATHER MCCANN MCINTOSH M.D.) exists in 1225119399 in HTML format HTML  |  1225119399 in plain Text format TXT  |  1225119399 in PDF (Portable Document Format) PDF  |  1225119399 in an XML format XML  formats.

NPI Number : 1225119399 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225119399",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCINTOSH",
    "FirstName": "HEATHER",
    "MiddleName": "MCCANN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCCANN",
    "OtherFirstName": "HEATHER",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "PO BOX 751649",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHARLOTTE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28275-1649",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "888-472-0043",
    "MailingAddressFaxNumber": "843-724-2440",
    "FirstLinePracticeLocationAddress": "615 WESLEY DR STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHARLESTON",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29407-7206",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "843-884-0302",
    "PracticeLocationAddressFaxNumber": "843-849-9308",
    "EnumerationDate": "10/17/2006",
    "LastUpdateDate": "04/28/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": "12753",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": "A 104055",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207XX0005X",
          "TaxonomyName": "Sports Medicine (Orthopaedic Surgery) Physician",
          "LicenseNumber": "26146",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": "26146",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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