Individual provider Active NPI

Cynthia A Heidorn, RN

  • School Registered Nurse
  • Belleville, IL
National Provider Identifier
1841703311
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
041255265 Issued in IL
Practice address
1801 Central School Rd
Belleville, IL 62220-3265
Phone
(618) 233-5377
NPI assigned
Nov 7, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 041255265 IL Primary

Addresses

Primary practice location

1801 Central School Rd
Belleville, IL 62220-3265

Mailing address

105 W a St
Belleville, IL 62220-1326
Phone (618) 234-4294

Other practice location 1

700 W Cleveland Ave
Belleville, IL 62220-2465
Phone (618) 233-1608

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
041255265ILMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Belleville School District 118 Past 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, 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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1841703311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W A ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201326",
            "telephone_number": "618-234-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CENTRAL SCHOOL RD",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203265",
            "telephone_number": "618-233-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622202465",
            "country_code": "US",
            "telephone_number": "618-233-1608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDORN",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "IL",
            "license": "041255265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.