Individual provider Active NPI

Anne Marie Heisserer, DC

  • Chiropractor
  • Cape Girardeau, MO
National Provider Identifier
1174502256
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6563 Issued in MO
Practice address
3232 Independence St
Cape Girardeau, MO 63701-4904
Phone
(573) 332-1111
Fax
(573) 332-0042
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6563 MO Primary

Addresses

Primary practice location

3232 Independence St
Cape Girardeau, MO 63701-4904

Mailing address

326 S Mount Auburn Rd Ste 103
Cape Girardeau, MO 63703-4907
Phone (573) 332-1111

Other identifiers 1

IdentifierTypeStateIssuer
755772704MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050228000066 MO Practitioner - Chiropractic 4880647171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

326 S Mount Auburn Rd
Suite 103
Cape Girardeau, MO 63703-4907
Phone (573) 332-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6563MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anne M. Heisserer, DC, LLC Chiropractor CurrentSince Dec 21, 2004 Accepting new patients

Locations

3232 Independence St
Cpe Girardeau, MO 63701
Phone (573) 332-1111

326 S Mount Auburn Rd
Ste 103
Cpe Girardeau, MO 63703
Phone (573) 332-1111

Organizations & group practices 1

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1174502256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 S MOUNT AUBURN RD STE 103",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034907",
            "telephone_number": "573-332-1111",
            "fax_number": "573-332-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014904",
            "telephone_number": "573-332-1111",
            "fax_number": "573-332-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISSERER",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "6563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755772704",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.