Individual provider Active NPI

Heather N Gullickson-Cowden, OD

  • Optometrist
  • Menomonie, WI
National Provider Identifier
1619944543
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3015-035 Issued in WI
Practice address
2409 Stout Rd
Menomonie, WI 54751-2757
Phone
(715) 231-3937
NPI assigned
Feb 28, 2006
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 545 ND
Optometrist 152W00000X 2581 MN
Optometrist 152W00000X 3015-035 WI Primary

Addresses

Primary practice location

2409 Stout Rd
Menomonie, WI 54751-2757

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-5222

Other practice location 1

733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone (715) 838-5222

Other names 1

  • Dr. Heather N Cowden Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hgullicksoncowden24960@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000075 WI Practitioner - Optometry 9537148176 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
545NCMDAddiction (Substance Use Disorder) Counselor
545NDMDPsychologist
3015-035WIMDOptometrist
3015WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Steven B Thom, MD PC Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

2409 Stout Rd
Menomonie, WI 54751
Phone (715) 231-3937

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1619944543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 STOUT RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512757",
            "telephone_number": "715-231-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016101",
            "country_code": "US",
            "telephone_number": "715-838-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLICKSON-COWDEN",
        "first_name": "HEATHER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "545",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3015-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hgullicksoncowden24960@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2409 Stout Rd",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547512757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "COWDEN",
            "middle_name": "N",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Menomonie, WI

Sources for this page

Verify at the official NPI Registry.