Individual provider Active NPI

Rachel Jane Heidgerd, CRNP

  • Adult Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1679838098
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN281462 Issued in GA
Practice address
5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342-5022
Phone
(404) 847-9999
Fax
(404) 531-8466
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AC001031 MD
Adult Health Nurse Practitioner 363LA2200X RN281462 GA Primary

Addresses

Primary practice location

5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342-5022

Mailing address

5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342-5022
Phone (404) 847-9999

Other identifiers 2

IdentifierTypeStateIssuer
010296900MedicaidFL
003160740AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN281462GAMDAdult Health Nurse Practitioner
AC001031MDMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: rachel.heidgerd.1@15749.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1679838098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425022",
            "telephone_number": "404-847-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425022",
            "telephone_number": "404-847-9999",
            "fax_number": "404-531-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDGERD",
        "first_name": "RACHEL",
        "middle_name": "JANE",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "AC001031",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN281462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010296900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003160740A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.