Individual provider Active NPI

Loni Jean Bedard, CNP

  • Neonatal Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1861515744
Registry record updated Feb 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
CP000122 Issued in SD
Practice address
353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone
(605) 719-8382
Fax
(605) 719-4934
NPI assigned
Apr 7, 2007
Sex
Female
Sole proprietor
No

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000122SDMDNeonatal Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lbedard.9633@regionalhealth.sdhealthlink.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X CP000122 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

353 Fairmont Blvd
Rapid City, SD 57701-7375

Mailing address

PO Box 3450
Rapid City, SD 57709-3450
Phone (605) 719-8382

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
R020229OtherSDRN LICENSE
4993179OtherSDWELLMARK
6829590MedicaidSD
CP000122OtherSDCNP LICENSE

Other names 1

NPPES NPI Registry
  • Loni Jean Hettich Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 16, 2008.

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203120000000",
    "number": "1861515744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3450",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577093450",
            "telephone_number": "605-719-8382",
            "fax_number": "605-719-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-719-8382",
            "fax_number": "605-719-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDARD",
        "first_name": "LONI",
        "middle_name": "JEAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2008-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SD",
            "license": "CP000122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R020229",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "4993179",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829590",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNP LICENSE",
            "identifier": "CP000122",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LONI",
            "last_name": "HETTICH",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; 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.