Individual provider Active NPI

Darlene R Heikkila, PA

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1902878762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
117481 Issued in MO
Practice address
4049 S Campbell Ave
Springfield, MO 65807-5303
Phone
(417) 890-5550
Fax
(417) 889-6898
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 117481 MO Primary

Addresses

Primary practice location

4049 S Campbell Ave
Springfield, MO 65807-5303

Mailing address

4049 S Campbell Ave
Springfield, MO 65807-5303
Phone (417) 890-5550

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
117481MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902878762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075303",
            "telephone_number": "417-890-5550",
            "fax_number": "417-889-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075303",
            "telephone_number": "417-890-5550",
            "fax_number": "417-889-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIKKILA",
        "first_name": "DARLENE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "117481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.