Bonni Nicole Heithold, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2011017906 Issued in MO

Practice address

1 Hospital Drive
Columbia, MO 65212

Phone

(573) 882-4438

Fax

(573) 884-9992

NPI assigned

Jul 13, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bonni.heithold@115443077021700.direct.elationemr.com

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.

• Big Tree Medical Group LLC

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1740858562
  Medicare reassignment NPD
• Little Tree Pediatric Urgent Care LLC

  • Urgent Care Clinic/Center
  • Columbia, MO
  • NPI 1992418461

  Pediatrics

  NPD (past)
• Tiger Pediatrics LLC

  • Pediatrics Physician
  • Columbia, MO
  • NPI 1871872770
  NPD (past)

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1265720106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65212",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65212",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITHOLD",
        "first_name": "BONNI",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011017906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farah Heis, MBBS
• Gerald Henry Heisler, PH.D.
• Ramona Elaine Heisler, PTA
• Ralph Lokke Heiss, M.D.
• Raquel Heisse, D.C.
• Kasey Heitzmann, CCC-SLP
• Paige Helgerson, OTR/L, MOT
• Ashley Colleen Helle, PHD
• Andrea Leigh Heller, M.H.S., CCC-SLP
• David W Helling, LCSW

• Pediatrics Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.