Heidi Richardson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Sep 11, 2017

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

• Heidi Grondahl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1962921049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Building 2, Del Din Clinic",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09606",
            "country_code": "US",
            "telephone_number": "314-636-9764",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "Building 2, Del Din Clinic",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09606",
            "country_code": "US",
            "telephone_number": "314-636-9764",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "65473",
            "country_code": "US",
            "telephone_number": "719-310-4153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654739098",
            "country_code": "US",
            "telephone_number": "719-310-4153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1722 Tagatay Street",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "38210",
            "country_code": "US",
            "telephone_number": "910-643-1923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "HEIDI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "GRONDAHL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather J Rhodes-Pope, PHARMD, MBA
• Omega Rhone, EFDA
• Chantsen Kye Rich, PT
• Jason Richard, APRN
• Jessica Richard, QP, MSW, LCSW
• Joseph M Richardson, DDS
• Tanissea Richardson
• William Richardson
• Marion Daniela Richgruber
• Edward Richter, LCSW

• Physician Assistant in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.