Individual provider Active NPI

Heidi L. Lee, APRN

  • Adult Health Nurse Practitioner
  • Campbellsville, KY
National Provider Identifier
1356324933
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3003647 Issued in KY
Practice address
67 Kingswood Dr
Campbellsville, KY 42718-9647
Phone
(270) 849-2379
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3003647 KY Primary

Addresses

Primary practice location

67 Kingswood Dr
Campbellsville, KY 42718-9647

Mailing address

67 Kingswood Dr
Campbellsville, KY 42718-9647
Phone (270) 849-2379

Other identifiers 3

IdentifierTypeStateIssuer
000000354691OtherKYANTHEM BCBS
000000597283OtherKYANTHEM BLUE CROSS
78006277MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001368 KY Practitioner - Nurse Practitioner 4183605256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3003647KYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Communicare Inc CurrentSince Mar 26, 2013 Accepting new patients
Communicare Inc CurrentSince Mar 26, 2013 Accepting new patients
Communicare Inc Current Accepting new patients
Elderserve, Inc. Past Accepting new patients
Cpo PSC PastSince Jul 1, 1999 Accepting new patients

Locations

1311 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 360-0419

107 Cranes Roost Ct
Elizabethtown, KY 42701
Phone (270) 765-2650

1072 S Dixie Blvd
Radcliff, KY 40160
Phone (270) 351-8166

Organizations & group practices 5

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1356324933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189647",
            "telephone_number": "270-849-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189647",
            "telephone_number": "270-849-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HEIDI",
        "middle_name": "L.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3003647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000354691",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000597283",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78006277",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.