Individual provider Active NPI

Lindsey Heidrick, MA, CCC-SLP

  • Speech-Language Pathologist
  • Kansas City, KS
National Provider Identifier
1679612469
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6869 Issued in NC
Practice address
3901 Rainbow Blvd
Mail Stop 3039
Kansas City, KS 66160
Phone
(913) 588-5937
Fax
(913) 588-5923
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6869 NC Primary
Speech-Language Pathologist 235Z00000X 3082 KS

Addresses

Primary practice location

3901 Rainbow Blvd
Mail Stop 3039
Kansas City, KS 66160

Mailing address

3901 Rainbow Blvd
Mail Stop 3039
Kansas City, KS 66160
Phone (913) 588-5937

Other identifiers 5

IdentifierTypeStateIssuer
140R4OtherNCBLUE CROSS BLUE SHIELD NC
7412354MedicaidNC
188258OtherNCMEDCOST PROVIDER ID
3082OtherKSSTATE OF KANSAS
2010014110OtherMOMISSOURI LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015000307 KS Practitioner - Qualified Speech Language Pathologist 0345433991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6869NCMDProfessional Counselor
3082KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc CurrentSince Sep 14, 2010 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Sep 14, 2010 Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

3599 Rainbow Blvd
Kansas City, KS 66103
Phone (913) 588-1203

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

3901 Rainbow Blvd
Stop 3039
Kansas City, KS 66160
Phone (913) 588-5937

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1679612469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MAIL STOP 3039",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-5937",
            "fax_number": "913-588-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MAIL STOP 3039",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-5937",
            "fax_number": "913-588-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDRICK",
        "first_name": "LINDSEY",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6869",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "3082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "140R4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412354",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER ID",
            "identifier": "188258",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF KANSAS",
            "identifier": "3082",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "2010014110",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.