NPIMap

Individual provider Active NPI

Heidi A Herold, MD

  • Family Medicine Physician
  • Coeur d'Alene, ID
National Provider Identifier
1043322217
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-13072 Issued in ID
Practice address
315 W Dalton Ave Ste B
Coeur D Alene, ID 83815-8600
Phone
(208) 209-2066
Fax
(208) 209-2076
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-13072 ID Primary

Addresses

Primary practice location

315 W Dalton Ave Ste B
Coeur D Alene, ID 83815-8600

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

Other identifiers 1

IdentifierTypeStateIssuer
1043322217MedicaidID

Other names 1

  • Heidi Wychanko Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151208002673 ID Practitioner - Family Practice 5294762613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

315 W Dalton Ave
Suite a
Coeur D Alene, ID 83815-8600
Phone (208) 209-2060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86057CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Oct 1, 2021 Accepting new patients
Redding ENT-Head and Neck Surgery Inc a Medical Group CurrentSince Oct 15, 2014 Accepting new patients
Heidi a Herold, MD Inc Family Medicine PastSince Oct 15, 2014 Accepting new patients
Jill Van Horn DO a Professional Corporation Family Medicine Past Accepting new patients
North Idaho Day Surgery LLC PastSince Aug 25, 2024 Accepting new patients

Locations

2143 Airpark Dr
Redding, CA 96001
Phone (530) 241-7477

315 W Dalton Ave
Ste A
Coeur D Alene, ID 83815
Phone (208) 209-2060

315 W Dalton Ave
Ste B
Coeur D Alene, ID 83815
Phone (208) 209-2066

7600 N Mineral Dr
Ste 450B
Coeur D Alene, ID 83815
Phone (208) 209-2066

7600 N Mineral Dr
Ste 450
Dalton Gardens, ID 83815
Phone (208) 457-4208

1551 E Mullan Ave
Ste 200B
Post Falls, ID 83854
Phone (208) 262-2213

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

Interoperability endpoints

  • Direct secure messaging: hherold@nwsh.gwaydirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1043322217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W DALTON AVE STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158600",
            "telephone_number": "208-209-2066",
            "fax_number": "208-209-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROLD",
        "first_name": "HEIDI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-13072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043322217",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "WYCHANKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.