Individual provider Active NPI

Heather Dejarnett

  • Advanced Practice Midwife
  • Stillwater, MN
National Provider Identifier
1609121508
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
12608 Issued in MN
Practice address
5640 Memorial Ave N
Suite B
Stillwater, MN 55082-2166
Phone
(651) 430-1880
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 12608 MN Primary

Addresses

Primary practice location

5640 Memorial Ave N
Suite B
Stillwater, MN 55082-2166

Mailing address

11133 Sweetwater Path
Woodbury, MN 55129-5293
Phone (651) 895-0055

Other names 1

  • Heather Dejarnett Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121022000140 MN Practitioner - Certified Nurse Midwife (CNM) 5496905820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare for Women, PA PastSince Jan 1, 2002 Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: heather.dejarnett@mwc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1609121508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 SWEETWATER PATH",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551295293",
            "telephone_number": "651-895-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 MEMORIAL AVE N",
            "address_2": "SUITE B",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550822166",
            "telephone_number": "651-430-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJARNETT",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "12608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "DEJARNETT",
            "credential": "CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.