Individual provider Active NPI

Heather L Haegele, F.N.P.

  • Family Nurse Practitioner
  • Arnold, MO
National Provider Identifier
1962595710
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
142540 Issued in MO
Practice address
3619 Richardson Square Dr
Suite 170
Arnold, MO 63010-6022
Phone
(636) 717-6776
Fax
(314) 525-4055
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 142540 MO
Family Nurse Practitioner 363LF0000X 142540 MO Primary

Addresses

Primary practice location

3619 Richardson Square Dr
Suite 170
Arnold, MO 63010-6022

Mailing address

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010-6022
Phone (636) 717-6776

Other identifiers 1

IdentifierTypeStateIssuer
428734008MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20041004000190 MO Practitioner - Nurse Practitioner 0345209631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

3619 Richardson Square Dr
Suite 170
Arnold, MO 63010-6014
Phone (636) 717-6776

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
142540MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients

Locations

3619 Richardson Square Dr
Ste 130
Arnold, MO 63010
Phone (636) 464-2888

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010
Phone (636) 717-6776

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

Interoperability endpoints

  • Direct secure messaging: hhaegele994388@directc.mercy.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1962595710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 RICHARDSON SQUARE DR",
            "address_2": "STE 170",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106022",
            "telephone_number": "636-717-6776",
            "fax_number": "314-525-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 RICHARDSON SQUARE DR",
            "address_2": "SUITE 170",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106022",
            "telephone_number": "636-717-6776",
            "fax_number": "314-525-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEGELE",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "142540",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "142540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428734008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.