Individual provider Active NPI

Heidi Nichols, CNP

  • Family Nurse Practitioner
  • Adrian, MI
National Provider Identifier
1972501138
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704140375 Issued in MI
Practice address
777 Kimole LN
Adrian, MI 49221-1478
Phone
(517) 263-3393
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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 4704140375 MI Primary

Addresses

Primary practice location

777 Kimole LN
Adrian, MI 49221-1478

Mailing address

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 479-5605

Other identifiers 3

IdentifierTypeStateIssuer
0355456MedicaidOH
P0024950OtherRAILROAD MEDICARE
0N11220OtherMIGROUP MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071212000402 MI Practitioner - Nurse Practitioner 0345330593 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1140 E Michigan Ave
Lansing, MI 48912-1806

1215 E Michigan Ave
Lansing, MI 48912-1811

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Clinton Hospital CurrentSince Sep 15, 2025 Accepting new patients
Sparrow Clinton Hospital CurrentSince Sep 15, 2025 Accepting new patients
Sparrow Ionia Hospital CurrentSince Sep 15, 2025 Accepting new patients
Sparrow Eaton Hospital CurrentSince Sep 15, 2025 Accepting new patients
Sparrow Eaton Hospital CurrentSince Sep 15, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Sparrow Ionia Hospital CurrentSince Sep 15, 2025 Accepting new patients
Sparrow Eaton Hospital CurrentSince Sep 15, 2025 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Sep 1, 2020 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Sep 1, 2020 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Sparrow Eaton Hospital Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

111 Lansing St
Ste 220
Charlotte, MI 48813
Phone (517) 543-9563

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

123 Lansing St
Ste 3C
Charlotte, MI 48813
Phone (517) 543-9564

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1355

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1140 E Michigan Ave
Ste 100
Lansing, MI 48912
Phone (517) 364-9402

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1140 E Michigan Ave
Ste 200
Lansing, MI 48912
Phone (517) 364-9400

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

901 S Oakland St
Saint Johns, MI 48879
Phone (517) 227-2338

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1972501138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211478",
            "telephone_number": "517-263-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "HEIDI",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704140375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0355456",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P0024950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "0N11220",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.