Individual provider Active NPI

Lonny Dean Heinemann

  • Acute Care Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1801372479
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CP001393 Issued in SD
Practice address
4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-7000
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X CP001393 SD Primary

Addresses

Primary practice location

4500 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

3704 W 86TH St
Sioux Falls, SD 57108-6208

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305003294 SD Practitioner - Nurse Practitioner 6204175474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP001393SDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Hospital of South Dakota LLC CurrentSince Jan 1, 2019 Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Jan 1, 2019 Accepting new patients

Locations

4500 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1801372479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 W 86TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINEMANN",
        "first_name": "LONNY",
        "middle_name": "DEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SD",
            "license": "CP001393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.