Active NPI
Patrice R Hedlund, PA C
- Physician Assistant
- Willmar, MN
National Provider Identifier
1558322719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9439
- Practice address
- 101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201 - Phone
- (320) 231-5079
- Fax
- (320) 231-5000
- NPI assigned
- Mar 29, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9439 | MN | Primary |
Addresses
Primary practice location
101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201
Mailing address
101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201
Phone (320) 231-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 640918100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1558322719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WILLMAR AVE SW",
"address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"city": "WILLMAR",
"state": "MN",
"postal_code": "56201",
"telephone_number": "320-231-5000",
"fax_number": "320-231-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WILLMAR AVE SW",
"address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
"city": "WILLMAR",
"state": "MN",
"postal_code": "56201",
"telephone_number": "320-231-5079",
"fax_number": "320-231-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDLUND",
"first_name": "PATRICE",
"middle_name": "R",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-29",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9439",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "640918100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.