Individual provider Active NPI

Angela Lowe Heider, MD

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1720054083
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC9356 Issued in ID
Practice address
209 E Carver St
Durham Womens Clinic
Durham, NC 27704
Phone
(919) 471-2273
Fax
(919) 479-0881
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC-9356 ID
Obstetrics & Gynecology Physician 207V00000X 200300614 NC
Mental Health Counselor 101YM0800X LCPC9356 ID Primary

Addresses

Primary practice location

209 E Carver St
Durham Womens Clinic
Durham, NC 27704

Mailing address

1579 W Riverstone Dr Ste 101
Coeur D Alene, ID 83814-1012
Phone (208) 435-0788

Other identifiers 1

IdentifierTypeStateIssuer
89127HYMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515002402 ID Practitioner - Mental Health Counselor 0547279358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1579 W Riverstone Dr
Suite 101
Coeur D Alene, ID 83814-1013

500 W Jefferson St
Louisville, KY 40202-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LCPC-9356IDMDMental Health Counselor
LCPC9356IDMDMental Health Counselor
200300614NCMDObstetrics & Gynecology Physician

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1720054083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 W RIVERSTONE DR STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838141012",
            "telephone_number": "208-435-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E CARVER ST",
            "address_2": "DURHAM WOMENS CLINIC",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-471-2273",
            "fax_number": "919-479-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDER",
        "first_name": "ANGELA",
        "middle_name": "LOWE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-9356",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200300614",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC9356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89127HY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.