Individual provider Active NPI

Heidi Marie Biedebach, MD

  • General Practice Physician
  • Big Bear Lake, CA
National Provider Identifier
1689907628
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
GFE72559 Issued in CA
Practice address
580 Thrush Drive
Big Bear Lake, CA 92315-0047
Phone
(760) 987-5613
Fax
(760) 297-2146
NPI assigned
Sep 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X GFE72559 CA Primary

Addresses

Primary practice location

580 Thrush Drive
Big Bear Lake, CA 92315-0047

Mailing address

PO Box 47
Big Bear Lake, CA 92315-0047
Phone (760) 987-5613

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GFE72559CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1689907628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923150047",
            "telephone_number": "760-987-5613",
            "fax_number": "760-297-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 THRUSH DRIVE",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923150047",
            "telephone_number": "760-987-5613",
            "fax_number": "760-297-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEDEBACH",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "GFE72559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Bear Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.