Provider Demographics
NPI:1669654836
Name:RINEY, HEIDI D (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:D
Last Name:RINEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4245 JOHNS CREEK PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-9122
Mailing Address - Country:US
Mailing Address - Phone:678-990-3962
Mailing Address - Fax:678-623-3862
Practice Address - Street 1:4245 JOHNS CREEK PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9122
Practice Address - Country:US
Practice Address - Phone:678-990-3962
Practice Address - Fax:678-623-3862
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0542682084N0600X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003126103BMedicaid
GA202I138406Medicare Oscar/Certification