Active NPI
Darla J Vanheerde, M.D.
- Family Medicine Physician
- Cloquet, MN
National Provider Identifier
1073695375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 29425
- Practice address
- 417 Skyline Blvd
Cloquet, MN 55720-1164 - Phone
- (218) 879-1271
- Fax
- (218) 879-9617
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 29425 | MN | Primary |
Addresses
Primary practice location
417 Skyline Blvd
Cloquet, MN 55720-1164
Mailing address
417 Skyline Blvd
Cloquet, MN 55720-1164
Phone (218) 879-1271
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0102271 | Other | FM | MEDICA |
| 06055VA | Other | MN | BLUES & FIRST PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1073695375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 SKYLINE BLVD",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201164",
"telephone_number": "218-879-1271",
"fax_number": "218-879-9617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 SKYLINE BLVD",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201164",
"telephone_number": "218-879-1271",
"fax_number": "218-879-9617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANHEERDE",
"first_name": "DARLA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "29425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0102271",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUES & FIRST PLAN",
"identifier": "06055VA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.