Heibel Dermatology Clinic LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

18056 Issued in NE

Legal business name

HEIBEL DERMATOLOGY CLINIC LLC

Practice address

7701 Preserve LN
Lincoln, NE 68516-4473

Phone

(402) 488-6969

Fax

(402) 488-6911

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Mark D Heibel, MDNPI 1417946484

Title

MD

Phone

(402) 488-6969

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark D Heibel, MD

  • Dermatology Physician
  • Lincoln, NE
  • NPI 1417946484
  Medicare reassignment Care Compare group NPD Authorized official
• Naomi Ann Sampson, MSN, FNP-C

  • Nurse Practitioner
  • Omaha, NE
  • NPI 1124250261
  Medicare reassignment Care Compare group NPD
• Nicholas James Jeffries, PA-C

  • Physician Assistant
  • Lincoln, NE
  • NPI 1033845888
  Medicare reassignment
• Andrea Noel Chrisman, APRN-NP

  • Nurse Practitioner
  • Grand Island, NE
  • NPI 1669783643
  NPD (past)
• Charles Milo Halverson, DPM

  • Foot Surgery Podiatrist
  • Fremont, NE
  • NPI 1821188558
  NPD (past)
• Rebecca A Reinke, PA

  • Medical Physician Assistant
  • Lincoln, NE
  • NPI 1649215807
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1073679940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 PRESERVE LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164473",
            "telephone_number": "402-488-6969",
            "fax_number": "402-488-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 PRESERVE LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164473",
            "telephone_number": "402-488-6969",
            "fax_number": "402-488-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIBEL DERMATOLOGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "HEIBEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "402-488-6969",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NE",
            "license": "18056",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NE",
            "license": "18056",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NE",
            "license": "18056",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "NE",
            "license": "18056",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NE",
            "license": "18056",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NE",
            "license": "18056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35672",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO-RAILROAD MEDICAR",
            "identifier": "CK4980",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Hegeholz, DDS
• Gena L Hegemann, MSW, LIMHP, LCSW
• Andrea M Hegge, PA-C
• Erin C Hegge, PA
• Dusty Hegwood
• Mark D Heibel, MD
• Nicole M Heibel, PHARMD
• Jill N Heidbrink, APRN
• Haley Heiden
• Cynthia Ann Heider Kaliff, LMHP

• Dermatology Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.