Active NPI
Heart to Heart Pediatrics LLC
- Pediatric Nurse Practitioner
- Waterloo, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- Legal business name
- HEART TO HEART PEDIATRICS LLC
- Practice address
- 224 Bradford LN
Waterloo, IL 62298-3369 - Phone
- (618) 939-0112
- NPI assigned
- Sep 10, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ginny M Peter, CPNP
- Title
- Nurse Practitioner
- Phone
- (618) 939-0112
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | Primary |
Addresses
Primary practice location
224 Bradford LN
Waterloo, IL 62298-3369
Mailing address
224 Bradford LN
Waterloo, IL 62298-3369
Phone (618) 939-0112
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2171616 | Heart to Heart Pediatrics, L L C | Certificate of waiver | Sep 4, 2027 |
National Provider Directory
National Provider DirectoryLocations
224 Bradford Ln
Waterloo, IL 62298
Phone (618) 939-0112
Interoperability endpoints
- https://api.platform.athenahealth.com/21224/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Waterloo, IL
- NPI 1740588805
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1569974400000",
"number": "1376192567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 BRADFORD LN",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622983369",
"telephone_number": "618-939-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 BRADFORD LN",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622983369",
"telephone_number": "618-939-0112"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEART TO HEART PEDIATRICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-10",
"last_updated": "2019-10-02",
"status": "A",
"authorized_official_last_name": "PETER",
"authorized_official_first_name": "GINNY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "618-939-0112",
"authorized_official_credential": "CPNP"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.