Individual provider Active NPI

Dena Geeta Heen, LRD

  • Registered Dietitian
  • Sartell, MN
National Provider Identifier
1487886842
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2191 Issued in MN
Practice address
1514 Pebble Creek Dr
Sartell, MN 56377-4521
Phone
(320) 293-5240
NPI assigned
Aug 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 881120 MN
Registered Dietitian 133V00000X 2191 MN Primary

Addresses

Primary practice location

1514 Pebble Creek Dr
Sartell, MN 56377-4521

Mailing address

1514 Pebble Creek Dr
Sartell, MN 56377-4521
Phone (320) 293-5240

Other practice location 1

1406 6th Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other names 1

  • Ms. Dena Geeta Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926004391 MN Practitioner - Registered Dietitian Or Nutrition Professional 4082145305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
881120MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients

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": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1487886842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 PEBBLE CREEK DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774521",
            "telephone_number": "320-293-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 PEBBLE CREEK DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774521",
            "telephone_number": "320-293-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031900",
            "country_code": "US",
            "telephone_number": "320-251-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEEN",
        "first_name": "DENA",
        "middle_name": "GEETA",
        "name_prefix": "Mrs.",
        "credential": "LRD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "881120",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENA",
            "last_name": "JOHNSON",
            "middle_name": "GEETA",
            "prefix": "MS.",
            "credential": "LRD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.