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MITCHELL THOMAS HEACOCK
NPI 1235973355
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since June 24, 2024PECOS Enrolled
350 W 14TH ST # 7024, INDIANAPOLIS, IN 46202(317) 278-2682 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 6, 2026, Jun 24, 2024 (2 updates tracked since 2024).

About Mitchell Thomas Heacock NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITCHELL THOMAS HEACOCK (NPI 1235973355) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Saginaw.

NPPES Registry Identity

NPI1235973355
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMITCHELL THOMAS HEACOCK
Location Address350 W 14TH ST # 7024Indianapolis, IN 46202-2369
Mailing Address700 Cooper AveSaginaw, MI 48602-5383
Phone(317) 278-2682
Sole ProprietorNo
Enumeration DateJune 24, 2024
Last NPPES UpdateApril 6, 20262 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
✔ NPI 1235973355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

350 W 14TH ST # 7024, Indianapolis, IN 46202
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Secondary Practice Location 1

Location 1700 Cooper AveSaginaw, MI 48602-5383 · Phone (989) 583-0000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mitchell Thomas Heacock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Heacock's NPI number?

The NPI number for Mitchell Heacock is 1235973355. It was assigned to this individual provider in the NPPES registry on June 24, 2024.

Where is Mitchell Heacock located?

Mitchell Heacock practices at 350 W 14th St # 7024, Indianapolis, IN 46202. The listed phone number is (317) 278-2682.

What is Mitchell Heacock's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mitchell Heacock enrolled in Medicare?

Yes. Mitchell Heacock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mitchell Heacock was last updated on April 6, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.