Individual provider Active NPI

Heather Pullen, FNP

  • Family Nurse Practitioner
  • Sikeston, MO
National Provider Identifier
1659987725
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020019146 Issued in MO
Practice address
1015 N Main St
Sikeston, MO 63801-5043
Phone
(573) 472-7777
Fax
(573) 931-8560
NPI assigned
Sep 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020019146 MO Primary

Addresses

Primary practice location

1015 N Main St
Sikeston, MO 63801-5043

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 472-7423

Other practice location 1

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 472-7423

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Sikeston Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200930000964 MO Practitioner - Nurse Practitioner 3678992393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020019146MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center CurrentSince Sep 28, 2020 Accepting new patients
Missouri Delta Medical Center CurrentSince Sep 28, 2020 Accepting new patients

Locations

1015 N Main St
Sikeston, MO 63801
Phone (573) 472-7120

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1659987725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015043",
            "telephone_number": "573-472-7777",
            "fax_number": "573-931-8560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015044",
            "country_code": "US",
            "telephone_number": "573-472-7423",
            "fax_number": "573-472-7475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "HEATHER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020019146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Sikeston",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1008 N Main St",
            "city": "Sikeston",
            "state": "MO",
            "country_code": "US",
            "postal_code": "638015044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.