NPIMap

Individual provider Active NPI

Heidi D Pratt, D.O.

  • Family Medicine Physician
  • Water Valley, MS
National Provider Identifier
1114980042
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS9122 Issued in FL
Practice address
604 S Main St
Water Valley, MS 38965-3468
Phone
(662) 473-1311
Fax
(662) 473-2489
NPI assigned
Apr 11, 2006
Last updated
Jun 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS9122 FL Primary

Addresses

Primary practice location

604 S Main St
Water Valley, MS 38965-3468

Mailing address

PO Box 728
Water Valley, MS 38965-0728
Phone (662) 473-1311

Other identifiers 2

IdentifierTypeStateIssuer
06075268MedicaidMS
273887200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080505000528 MS Practitioner - Family Practice 8921027384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yalobusha General HospitalGroup PAC ID 4486601648, 19 clinicians

Practice addresses (Care Compare)

11334 Hwy 315
Water Valley, MS 38965

604 S Main St
Water Valley, MS 38965-3468
Phone (662) 473-4050

606 S Main St
Water Valley, MS 38965-3468

630 S Main St
Water Valley, MS 38965-3468

PO Box
Suite 728
Water Valley, MS 38965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS9122FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yalobusha General Hospital CurrentSince Feb 2, 2018 Accepting new patients
Yalobusha General Hospital Past Accepting new patients
Yalobusha County Nursing Home Dba Yalobusha General Hospital Past Accepting new patients

Locations

604 S Main St
Water Valley, MS 38965
Phone (662) 473-1311

Interoperability endpoints

  • Direct secure messaging: heidi.pratt.1@15461.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1114980042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389650728",
            "telephone_number": "662-473-1311",
            "fax_number": "662-473-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S MAIN ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389653468",
            "telephone_number": "662-473-1311",
            "fax_number": "662-473-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "HEIDI",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06075268",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273887200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Water Valley, MS

Sources for this page

Verify at the official NPI Registry.