Active NPI
Heather Alison Brekke, PA-C, ATC
- Physician Assistant
- Wahpeton, ND
National Provider Identifier
1447765797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 332 2ND Ave N
Wahpeton, ND 58075-4528 - Phone
- (701) 642-7000
- NPI assigned
- Dec 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Athletic Trainer | 2255A2300X | 559-14 | ND |
Addresses
Primary practice location
332 2ND Ave N
Wahpeton, ND 58075-4528
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
800 6th St N
Wahpeton, ND 58076-0001
Phone (701) 671-2309
Other names 1
- Heather Alison Bates
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.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000
332 2ND Ave N
Wahpeton, ND 58075-4528
Phone (701) 642-7000
69 Hwy 13 W
Gwinner, ND 58040-4127
Phone (701) 678-2263
Hospital & facility affiliations
- Sanford Medical Center Fargo
- St Francis Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220909001893 | ND | Practitioner - Physician Assistant | 8820473945 | Reassigns benefits to 1 organization |
| I20241023004671 | MN | Practitioner - Physician Assistant | 8820473945 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 559-14 | ND | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
332 2nd Ave N
Wahpeton, ND 58075
Phone (701) 642-7000
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1447765797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 2ND AVE N",
"city": "WAHPETON",
"state": "ND",
"postal_code": "580754528",
"telephone_number": "701-642-7000"
}
],
"practiceLocations": [
{
"address_1": "800 6th St N",
"address_purpose": "LOCATION",
"city": "Wahpeton",
"state": "ND",
"postal_code": "580760001",
"country_code": "US",
"telephone_number": "701-671-2309",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BREKKE",
"first_name": "HEATHER",
"middle_name": "ALISON",
"credential": "PA-C, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-08",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": "559-14",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "BATES",
"middle_name": "ALISON",
"credential": "HEATHER ALISON BATES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wahpeton, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.
- 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.