Colleen S Hebert, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2429-035 Issued in WI

Practice address

740 Reena Ave
Suite B
Fort Atkinson, WI 53538-3145

Phone

(920) 563-8468

Fax

(920) 563-7018

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1114948221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "COLLEEN",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2429-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114948221",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chebert260507@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "chebert260507@direct-ehr-ssmhc.com",
            "address_1": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Hayes
• Healing Your Mind Counseling
• Healogics Specialty Physicians of Wisconsin, LLC
• Healthy Sleep Madison LLC
• Heatherlyn Assisted Living LLC
• Karla Heikkinen, RDN
• Kimberly Heine, MA, LPC
• Anne Hepperla
• Ronita Hickman, RDH
• Hidden Path Counseling, LLC

• Optometrist in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.