Individual provider Active NPI

Heidi Leigh Heise, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wausau, WI
National Provider Identifier
1386954733
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4214 Issued in WI
Practice address
1100 Lake View Dr
Wausau, WI 54403-6799
Phone
(715) 848-4600
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4214 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4214 WI Primary

Addresses

Primary practice location

1100 Lake View Dr
Wausau, WI 54403-6799

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110318000098 WI Practitioner - Nurse Practitioner 5698958346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 Langlade Rd
Antigo, WI 54409-2762
Phone (715) 627-6694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services Board Serving North Central Health Care Facility CurrentSince Feb 22, 2021 Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Feb 22, 2021 Accepting new patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients

Locations

1225 Langlade Rd
Antigo, WI 54409
Phone (715) 623-2394

607 N Sales St
Ste 309
Merrill, WI 54452
Phone (715) 536-9482

607 N Sales St
Merrill, WI 54452
Phone (715) 536-0307

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

Organizations & group practices 3

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1386954733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799",
            "telephone_number": "715-848-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISE",
        "first_name": "HEIDI",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4214",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "4214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.