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DR. JAMES DAVID HEATON M.D.
NPI 1245551902
Emergency Medicine in Nags Head, NC

Active since June 17, 2010PECOS Enrolled
98.33/100
CMS Quality Rating
4800 S CROATAN HWY, NAGS HEAD, NC 27959(252) 449-5600 Get Directions Write a Review

NPPES record last updated: February 27, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 27, 2023, Jul 11, 2018, Apr 16, 2018 and 1 more (4 updates tracked since 2016).

About Dr. James David Heaton M.d. NPPES

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

DR. JAMES DAVID HEATON M.D. (NPI 1245551902) is an individual emergency medicine provider in Nags Head, North Carolina, licensed in North Carolina (233639) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1245551902
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JAMES DAVID HEATONCredential: M.D.
Location Address4800 S CROATAN HWYNags Head, NC 27959-9704
Mailing Address7049 Currituck RdKitty Hawk, NC 27949-3810 · (770) 355-2104
Phone(252) 449-5600
Sole ProprietorYes
Enumeration DateJune 17, 2010
Last NPPES UpdateFebruary 27, 20234 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2023
✔ NPI 1245551902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NC · 233639
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
4800 S CROATAN HWY, Nags Head, NC 27959
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Secondary Practice Locations 2

Location 1530 S Jackson St, Department of Emergency Medicine #C1H17Louisville, KY 40202-1675 · Phone (502) 852-5689 · Fax (502) 852-0066
Location 21144 N Road StElizabeth City, NC 27909 · Phone (252) 335-0531

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. James David Heaton M.d. 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.

Medicare Billing Reassignments

2

Medicare enrollment records show James Heaton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Outer Banks Professional Services, LLC
Same address
Urgent Care
4800 S CROATAN HWY
Nags Head, NC 27959
  • Reassigned Medicare billing, North Carolina enrollment
  • 346 clinicians in this Medicare group
NPI 1386182608 (252) 449-4500
Vidant Medical Group LLC
103 mi
Multi-Specialty
2100 STANTONSBURG RD
Greenville, NC 27834
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,653 clinicians in this Medicare group
NPI 1477648731 (252) 847-2181

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
201 services190 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
113 services112 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
38 services37 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27959 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.93
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CYNTHIA GAIL SHAHED NP-C
Nurse Practitioner (Adult Health)
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4500
THE OUTER BANKS HOSPITAL INC
General Acute Care Hospital (Critical Access)
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4500
CHRISTOPHER WINSTEAD-DERLEGA M.D. MPH
Emergency Medicine
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (125) 244-9450
JOHN P. LOIS III D.O.
Emergency Medicine
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4500
BENJAMIN STRIBLING ALEXANDER M.D.
Pediatrics
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4500
MRS. JACLYN EVA HALL RDN, LDN
Dietitian, Registered
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-7301
OUTER BANK HOSPITAL INC
Pharmacy (Institutional Pharmacy)
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4570
DR. AMANDA NICOLE MARKER DO
Emergency Medicine
4800 S CROATAN HWY
NAGS HEAD, NC 27959
Dare County (252) 449-4500

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 James Heaton's NPI number?

The NPI number for James Heaton is 1245551902. It was assigned to this individual provider in the NPPES registry on June 17, 2010.

Where is James Heaton located?

James Heaton practices at 4800 S Croatan Hwy, Nags Head, NC 27959. The listed phone number is (252) 449-5600.

What is James Heaton's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is James Heaton enrolled in Medicare?

Yes. James Heaton is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for James Heaton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Heaton reassigns Medicare benefits to 2 organizations: Outer Banks Professional Services, LLC (Nags Head, NC) and Vidant Medical Group LLC (Greenville, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Heaton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Heaton accept?

Health plans from Cigna Healthcare list James Heaton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Heaton was last updated on February 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.