Individual provider Active NPI

Heidi Kay Pedersen, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Storm Lake, IA
National Provider Identifier
1467092049
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G176868 Issued in IA
Practice address
728 Erie Steet
Storm Lake, IA 50588
Phone
(712) 213-8402
Fax
(712) 213-8411
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 A157446 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G176868 IA Primary

Addresses

Primary practice location

728 Erie Steet
Storm Lake, IA 50588

Mailing address

728 Erie Street
Storm Lake, IA 50588
Phone (712) 213-8402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20200310002471 IA Practitioner - Nurse Practitioner 5597193359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Plains Area Mental Health IncGroup PAC ID 5395649743, 24 clinicians

Practice addresses (Care Compare)

180 10TH St SE
Suite 201
Le Mars, IA 51031-2557
Phone (712) 546-4624

Hospital & facility affiliations

  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124
  • Crawford County Memorial Hospital Hospital, Denison, IA, CCN 161369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A157446IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Plains Area Mental Health, Inc. CurrentSince Jan 22, 2024 Accepting new patients
Plains Area Mental Health, Inc. CurrentSince Jan 22, 2024 Accepting new patients

Locations

180 10th St SE
Ste 201
Le Mars, IA 51031
Phone 7125464624 ext. 2108

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1467092049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 ERIE STREET",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "50588",
            "telephone_number": "712-213-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 ERIE STEET",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "50588",
            "telephone_number": "712-213-8402",
            "fax_number": "712-213-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "HEIDI",
        "middle_name": "KAY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A157446",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G176868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

Verify at the official NPI Registry.