Individual provider Active NPI

Heather Myree Anderson, FNP-BC

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1962279216
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014794A Issued in IN
Practice address
2100 N Main St # 304
Crown Point, IN 46307-1877
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 71014794A IN Primary

Addresses

Primary practice location

2100 N Main St # 304
Crown Point, IN 46307-1877

Mailing address

34 S Main St
Cloverdale, IN 46120-8531
Phone (888) 837-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240123003742 IN Practitioner - Nurse Practitioner 2668824806 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71014794AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 18, 2024 Accepting new patients
Theoria Medical CurrentSince Apr 17, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 18, 2024 Accepting new patients

Locations

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

3 N Manatee St
Brazil, IN 47834
Phone (812) 531-1127

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

402 19th St
Tell City, IN 47586
Phone (812) 547-3427

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1962279216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 S MAIN ST",
            "city": "CLOVERDALE",
            "state": "IN",
            "postal_code": "461208531",
            "telephone_number": "888-837-5440",
            "fax_number": "574-546-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST # 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "HEATHER",
        "middle_name": "MYREE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014794A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.