Individual provider Active NPI

Nikki Heiderscheidt

  • Pharmacist
  • Sleepy Eye, MN
National Provider Identifier
1689380149
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
125254 Issued in MN
Practice address
121 1St Ave S
Sleepy Eye, MN 56085-1364
Phone
(507) 794-3631
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 125254 MN Primary

Addresses

Primary practice location

121 1St Ave S
Sleepy Eye, MN 56085-1364

Mailing address

538 3Rd Ave NW
Sleepy Eye, MN 56085-1037

Other practice location 1

400 4th Ave NW
Sleepy Eye, MN 56085-1109
Phone (507) 794-8450

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125254MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Randys Family Drug & Gift Inc PastSince Jan 29, 2023 Accepting new patients

Organizations & group practices 1

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": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1689380149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 3RD AVE NW",
            "city": "SLEEPY EYE",
            "state": "MN",
            "postal_code": "560851037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 1ST AVE S",
            "city": "SLEEPY EYE",
            "state": "MN",
            "postal_code": "560851364",
            "telephone_number": "507-794-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 4th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Sleepy Eye",
            "state": "MN",
            "postal_code": "560851109",
            "country_code": "US",
            "telephone_number": "507-794-8450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDERSCHEIDT",
        "first_name": "NIKKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Eye, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.