NPIMap

Individual provider Active NPI

Heidi Ann Hansen, APRN, CNP

  • Family Nurse Practitioner
  • Ivanhoe, MN
National Provider Identifier
1629414578
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3686 Issued in MN
Practice address
366 E George St
Ivanhoe, MN 56142-9711
Phone
(507) 694-1377
Fax
(507) 694-1379
NPI assigned
May 20, 2013
Last updated
Mar 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3686 MN Primary
Registered Nurse 163W00000X R180645-2 MN

Addresses

Primary practice location

366 E George St
Ivanhoe, MN 56142-9711

Mailing address

366 E George St
Ivanhoe, MN 56142-9711
Phone (507) 694-1377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000394 MN Practitioner - Nurse Practitioner 4385885334 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Tyler Medical Clinic IncGroup PAC ID 1557252533, 4 clinicians
Avera TylerGroup PAC ID 9638088537, shared by 5 NPIs, 15 clinicians

Practice addresses (Care Compare)

109 E Benton St
Lake Benton, MN 56149-1309
Phone (507) 368-4323

240 Willow St
Tyler, MN 56178-1166
Phone (507) 247-5921

240 Willow St
Tyler, MN 56178-1201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R180645-2MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Tyler CurrentSince Jan 1, 2016 Accepting new patients
Avera Tyler Family CurrentSince Jan 15, 2018 Accepting new patients
Avera Tyler Current Accepting new patients
Avera Marshall CurrentSince Jul 1, 2013 Accepting new patients
Avera Marshall CurrentSince Jul 1, 2013 Accepting new patients
Avera Marshall Current Accepting new patients
Avera Tyler CurrentSince Jan 1, 2016 Accepting new patients
Avera Tyler Current Accepting new patients

Locations

109 E Benton St
Lake Benton, MN 56149
Phone (507) 368-4323

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

Interoperability endpoints

  • Direct secure messaging: heidi.hansen@avera.sdhealthlink.net

Organizations & group practices 8

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1629414578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 E GEORGE ST",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561429711",
            "telephone_number": "507-694-1377",
            "fax_number": "507-694-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 E GEORGE ST",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561429711",
            "telephone_number": "507-694-1377",
            "fax_number": "507-694-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "HEIDI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "3686",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R180645-2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ivanhoe, MN

Sources for this page

Verify at the official NPI Registry.