Active NPI
Jeanna C. Heidel, PHARMD
- Pharmacist
- Rusk, TX
National Provider Identifier
1093758229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30088
- Practice address
- 1601 N Dickinson
Pharmacy
Rusk, TX 75785 - Phone
- (903) 683-7174
- Fax
- (903) 683-7996
- NPI assigned
- Jun 14, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30088 | TX | Primary |
Addresses
Primary practice location
1601 N Dickinson
Pharmacy
Rusk, TX 75785
Mailing address
RR 3 Box 163
Rusk, TX 75785-9527
Phone (903) 683-2045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30066 | Other | TX | STATE PHARMACIST LISCENSE |
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30088 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1093758229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 3 BOX 163",
"city": "RUSK",
"state": "TX",
"postal_code": "757859527",
"telephone_number": "903-683-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 N DICKINSON",
"address_2": "PHARMACY",
"city": "RUSK",
"state": "TX",
"postal_code": "75785",
"telephone_number": "903-683-7174",
"fax_number": "903-683-7996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIDEL",
"first_name": "JEANNA",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "30088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LISCENSE",
"identifier": "30066",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rusk, TX
- Rick Hale
- Larry R Hawkins, MD
- Health and Human Services Commission (Rusk State Hospital Pharmacy)
- Health and Human Services Commission (Rusk State Hospital)
- Health and Human Services Commission (Rusk State Hospital)
- Linda Henderson, FNP
- Jami Lynn Hicks, APRN, CPNP-PC
- Amir Ali Homayounkhah, PMHNP-BC
- Jackets Contractors & Associates LLC
- Jacksonville Hospital LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.