Heather Nicole Nancy Schake Moellers, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001357-15 Issued in WI

Practice address

75 Sherry Ave
Park Falls, WI 54552-1468

Phone

(715) 762-0200

NPI assigned

May 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Nicole Nancy Schake Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Family Health Center of Marshfield Inc

  • Federally Qualified Health Center (FQHC)
  • Park Falls, WI
  • NPI 1063104297
  NPD (past)
• Family Health Center of Marshfield Inc

  • Federally Qualified Health Center (FQHC)
  • Wisconsin Rapids, WI
  • NPI 1679447569
  NPD (past)

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

{
    "created_epoch": "1462665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1891141933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521468",
            "telephone_number": "715-762-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521468",
            "telephone_number": "715-762-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLERS",
        "first_name": "HEATHER",
        "middle_name": "NICOLE NANCY SCHAKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-08",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001357-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "SCHAKE",
            "middle_name": "NICOLE NANCY",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rhonda Jean Madigan, COTA
• Manor Medical Supply Inc.
• Daniel L Marsh, DDS
• Cindy Martin, COTA
• Mia Mittelstadt-Bleicher
• Randy Allan Musack, D.O., D.V.M.
• Lauri Neibauer
• James William Nesbit, A.T.C./L.A.T.
• Nancy T. Nesbit, DPT, LAT, CSCS
• Latasha Lynn Newbury, OTR/L

• Dentist in Park Falls, WI
• Providers in Park Falls, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.