Individual provider Active NPI

Rachel Ellen Ridenour Herman, MS RN CNP

  • Critical Care Pediatric Nurse Practitioner
  • Altoona, IA
National Provider Identifier
1992772107
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
C166816 Issued in IA
Practice address
1210 1St Ave N
Altoona, IA 50009-4804
Phone
(515) 967-8887
Fax
(833) 913-0981
NPI assigned
Mar 7, 2006
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X C166816 IA Primary
Critical Care Pediatric Nurse Practitioner 363LP0222X MN R 1297074 MN

Addresses

Primary practice location

1210 1St Ave N
Altoona, IA 50009-4804

Mailing address

1210 1St Ave N
Altoona, IA 50009-4804
Phone (515) 967-8887

Other practice location 1

5975 Carmen Ave
Inver Grove Heights, MN 55076-4416
Phone (651) 455-9697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20240926001355 VI Practitioner - Nurse Practitioner 0244295343 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
C166816IAMDCritical Care Pediatric Nurse Practitioner
MN R 1297074MNMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The St Thomas East End Medical Center Corporation CurrentSince Aug 6, 2024 Accepting new patients
Bluestem Center for Child and Family Development, P.a. PastSince Jan 29, 1996 Accepting new patients
Be Well Pediatrics, P.L.C Past Accepting new patients

Locations

4605 Tutu Park Mall
Ste 207
St Thomas, VI 00802
Phone (340) 775-3700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25081/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1992772107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 1ST AVE N",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500094804",
            "telephone_number": "515-967-8887",
            "fax_number": "833-913-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 1ST AVE N",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500094804",
            "telephone_number": "515-967-8887",
            "fax_number": "833-913-0981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5975 Carmen Ave",
            "address_purpose": "LOCATION",
            "city": "Inver Grove Heights",
            "state": "MN",
            "postal_code": "550764416",
            "country_code": "US",
            "telephone_number": "651-455-9697",
            "fax_number": "651-455-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "RACHEL",
        "middle_name": "ELLEN RIDENOUR",
        "credential": "MS RN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "IA",
            "license": "C166816",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MN",
            "license": "MN R 1297074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, IA

Sources for this page

Verify at the official NPI Registry.