Individual provider Active NPI

Annie M Hegg, PHARM.D.

  • Pharmacist
  • Waconia, MN
National Provider Identifier
1104033547
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
118533 Issued in MN
Practice address
500 S Maple St
Attn: Pharmacy
Waconia, MN 55387-1752
Phone
(952) 442-2191
Fax
(952) 442-6533
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 118533 MN Primary
Pharmacist 183500000X 5461 SD

Addresses

Primary practice location

500 S Maple St
Attn: Pharmacy
Waconia, MN 55387-1752

Mailing address

3110 N Chestnut St Unit 490
Chaska, MN 55318-4593
Phone (507) 828-4882

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

LicenseStateTypeSpecialty
118533MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1104033547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 N CHESTNUT ST UNIT 490",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184593",
            "telephone_number": "507-828-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "address_2": "ATTN: PHARMACY",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGG",
        "first_name": "ANNIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118533",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.