Individual provider Active NPI

Heather S Dixon, FNP

  • Family Nurse Practitioner
  • Troy, MO
National Provider Identifier
1083090013
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015006343 Issued in MO
Practice address
1000 E Cherry St
Troy, MO 63379-1513
Phone
(636) 528-3495
NPI assigned
Jul 31, 2015
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015006343 MO Primary

Addresses

Primary practice location

1000 E Cherry St
Troy, MO 63379-1513

Mailing address

1000 E Cherry St
Troy, MO 63379-1513
Phone (636) 528-3495

Other names 1

  • Heather S Bostic Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202000346 MO Practitioner - Nurse Practitioner 2062712722 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2015006343MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Oct 30, 2016 Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

625 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-0175

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1083090013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-528-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-528-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "HEATHER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015006343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "BOSTIC",
            "middle_name": "S",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.