Active NPI
Mary K Heimmermann, APNP
- Nurse Practitioner
- Neenah, WI
National Provider Identifier
1578795407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3841-033
- Practice address
- 411 Lincoln St
Network House Calls
Neenah, WI 54956-2753 - Phone
- (920) 886-0818
- Fax
- (920) 427-1310
- NPI assigned
- Aug 11, 2009
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3841-033 | WI | Primary |
Addresses
Primary practice location
411 Lincoln St
Network House Calls
Neenah, WI 54956-2753
Mailing address
411 Lincoln St
Network House Calls
Neenah, WI 54956-2753
Phone (920) 886-0818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100005319 | Medicaid | WI |
Other names 1
- Mrs. Mary K Heimmermann
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3841-033 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare Medical Center - Shawano, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Shawano, WI
- NPI 1548260839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350518400000",
"number": "1578795407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 LINCOLN ST",
"address_2": "NETWORK HOUSE CALLS",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562753",
"telephone_number": "920-886-0818",
"fax_number": "920-427-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 LINCOLN ST",
"address_2": "NETWORK HOUSE CALLS",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562753",
"telephone_number": "920-886-0818",
"fax_number": "920-427-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIMMERMANN",
"first_name": "MARY",
"middle_name": "K",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-11",
"last_updated": "2012-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "3841-033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100005319",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "HEIMMERMANN",
"middle_name": "K",
"prefix": "MRS.",
"credential": "APNP",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.