Individual provider Active NPI

Alicia Heckman, PHARMD

  • Pharmacist
  • South Portland, ME
National Provider Identifier
1104420215
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR12505 Issued in ME
Practice address
415 Philbrook Ave
South Portland, ME 04106-3215
Phone
(207) 772-0758
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR12505 ME Primary

Addresses

Primary practice location

415 Philbrook Ave
South Portland, ME 04106-3215

Mailing address

415 Philbrook Ave
South Portland, ME 04106-3215
Phone (207) 772-0758

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
PR12505MEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hannaford Bros Co LLC PastSince Dec 6, 2020 Accepting new patients
Hannaford Bros. Co., LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1104420215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 PHILBROOK AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063215",
            "telephone_number": "207-772-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 PHILBROOK AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063215",
            "telephone_number": "207-772-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKMAN",
        "first_name": "ALICIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR12505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.