Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bethany Kate Heaton, PA-C

Individual provider Medical Physician Assistant · NPI 1104228568

Bethany Kate Heaton, PA-C is a Physician Assistant in Randallstown, Maryland. Qualified in 2014, 12 years ago. Practices with Lifebridge Community Physicians Inc, a 185-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
12
Licensed in
MD
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone: (410) 521-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence C05554 (MD)

Record details

NPI number1104228568
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 17, 2014
Last updated in NPPESApril 16, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Lifebridge Community Physicians Inc — 185 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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