Individual provider Active NPI

Chanel Marie Heermann, M.D.

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1043266562
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0044171 Issued in CO
Practice address
Unmc Psychiatry
985575 Nebraska Medical Center
Omaha, NE 68198-0001
Phone
(402) 552-6002
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 31232 AZ
Psychiatry Physician 2084P0800X 23689 NE
Psychiatry Physician 2084P0800X DR.0044171 CO Primary

Addresses

Primary practice location

Unmc Psychiatry
985575 Nebraska Medical Center
Omaha, NE 68198-0001

Mailing address

7609 Springfield Dr
Omaha, NE 68114-1610
Phone (308) 224-0191

Other identifiers 1

IdentifierTypeStateIssuer
777849-03MedicaidAZ

Other names 1

  • Ms. Chanel Marie Vandewege Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260324001423 CA Practitioner - Psychiatry 8224086889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Academy
Suite 100
Irvine, CA 92617-3024

55 Magnolia Vine LN
Smithfield, NC 27577-7385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31232AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Bergan Mercy Health System Psychiatry Past Accepting new patients
State of Nebraska Dept of Admin Services Past Accepting new patients
University Physicians Healthcare Psychiatry Past Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1043266562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 SPRINGFIELD DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141610",
            "telephone_number": "308-224-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNMC PSYCHIATRY",
            "address_2": "985575 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "402-552-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEERMANN",
        "first_name": "CHANEL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "31232",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "23689",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0044171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777849-03",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANEL",
            "last_name": "VANDEWEGE",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.