Individual provider Active NPI

Leslie N. Heddleston, MD

  • Maternal & Fetal Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1639240732
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
3758 Issued in SD
Practice address
1417 S Cliff Ave
Ste 100
Sioux Falls, SD 57105-1063
Phone
(605) 322-8937
Fax
(605) 322-8938
NPI assigned
Nov 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 3758 SD Primary

Addresses

Primary practice location

1417 S Cliff Ave
Ste 100
Sioux Falls, SD 57105-1063

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 18

IdentifierTypeStateIssuer
1639240732OtherSDARAZ/AMERICA'S PPO
283761009502OtherSDPREFERRED ONE
774219300MedicaidMN
HP30795OtherSDHEALTHPARTNERS
1639240732MedicaidIA
1658OtherSDMIDLANDS CHOICE
3758OtherSDSD STATE LICENSE
G54151OtherCACALIFORNIA STATE LICENSE
6200053MedicaidSD
10025040700MedicaidNE
3758OtherSDDAKOTACARE
4993265OtherSDBLUE CROSS
370624200OtherSDDEPT OF LABOR
57105AD06OtherSDWPS TRICARE
658C9HEOtherMNBLUE CROSS
658C9HEOtherMNCC SYSTEMS/ BLUE PLUS
924114229808OtherMNPRIMEWEST
1639240732OtherSDMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Maternal & Fetal Medicine CurrentSince Apr 23, 2007 Accepting new patients
Avera McKennan CurrentSince Apr 23, 2007 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

323 SW 10th St
Madison, SD 57042
Phone (605) 256-6551

1417 S Cliff Ave
Ste 100
Sioux Falls, SD 57105
Phone (605) 322-7580

Interoperability endpoints

  • Direct secure messaging: les.heddleston@avera.sdhealthlink.net

Organizations & group practices 3

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": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1639240732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051063",
            "telephone_number": "605-322-8937",
            "fax_number": "605-322-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDDLESTON",
        "first_name": "LESLIE",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "SD",
            "license": "3758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/AMERICA'S PPO",
            "identifier": "1639240732",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "283761009502",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774219300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP30795",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639240732",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "1658",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD STATE LICENSE",
            "identifier": "3758",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "G54151",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6200053",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025040700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "3758",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4993265",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "370624200",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57105AD06",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "658C9HE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "658C9HE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "924114229808",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1639240732",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.