Individual provider Active NPI

Nick Heeter, RN

  • Registered Nurse
  • Monett, MO
National Provider Identifier
1740713841
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2016006114 Issued in MO
Practice address
411 3Rd St
Monett, MO 65708-2008
Phone
(417) 476-1000
Fax
(417) 476-1082
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2016006114 MO Primary

Addresses

Primary practice location

411 3Rd St
Monett, MO 65708-2008

Mailing address

PO Box 100
Pierce City, MO 65723-2100
Phone (417) 476-1000

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2016006114MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Community Mentalhealth Center Past Accepting new patients
Clark Community Mental Health Center PastSince Mar 25, 2015 Accepting new patients

Organizations & group practices 2

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1740713841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "PIERCE CITY",
            "state": "MO",
            "postal_code": "657232100",
            "telephone_number": "417-476-1000",
            "fax_number": "417-476-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 3RD ST",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657082008",
            "telephone_number": "417-476-1000",
            "fax_number": "417-476-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEETER",
        "first_name": "NICK",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2016006114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.