Kelly Heidepriem, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

LP03992 Issued in RI

Practice address

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Phone

(605) 322-2000

NPI assigned

Jun 20, 2017

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

Other identifiers 1

Other names 1

• Kelly Wong Former name

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avera McKennan

  dba Avera McKennan Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Woodbury Emergency Group, PC

  • Emergency Medicine Physician
  • Sioux City, IA
  • NPI 1447813316
  Medicare reassignment NPD
• Avera McKennan

  dba Avera Interventional Radiology

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  dba Avera Medical Group Intensivists Sioux Falls

  • Critical Care Medicine (Internal Medicine) Physician
  • Sioux Falls, SD
  • NPI 1972837979
  NPD

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1376073593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEPRIEM",
        "first_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "LP03992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LP03992",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WONG",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Elizabeth Hegyi, DO, MA
• Caleb Joseph Heiberger, MD
• Liza Heidelberger
• Leah Schmelkin Heidenreich, M.D.
• Mark Heidenreich, M.D.
• Heidi Jans Counseling, LLC
• Jeffrey Heier, MD
• Karen Heiling, M.D.
• Natalie Heiman, RN
• Rick Heiman

• Emergency Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Emergency Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.