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

Individual provider Physician Assistant · NPI 1962238691

Mackenzie Shiann Heaton, PA-C is a Physician Assistant in Johnson City, Tennessee. Qualified in 2025, 1 year ago. Registered with an NPI since 2024.

Years since qualifying
1
In the registry since
2024
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

2410 Susannah St
Johnson City, TN 37601-1748
Phone: (423) 282-9011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1962238691
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 10, 2024
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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