DR. PHILLIP M HEIDEPRIEM (NPI# 1891751970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891751970 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP M HEIDEPRIEM |
| Credential | MD |
| Practice Address |
2000 Pepperell Pkwy Opelika AL 36801-5452 |
| Mailing Address |
Po Box 4283 Opelika AL 36803-4283 |
| Practice Telephone | 3345281112 |
| Practice Fax Number | 3345281547 |
| Mailing Telephone | 3345281112 |
| Mailing Fax Number | 3345281547 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
12162 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS OF AL PROV # | 515-50415 | 01 |
| Street Address |
2000 PEPPERELL PKWY |
| City | OPELIKA |
| State | AL |
| Zip Code | 36801-5452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467452532 | John F Cabelka II | Radiology | 2000 Pepperell Pkwy, Radiation Oncology, Opelika, AL 36801-5452 | 2005-07-29 |
| 1437766185 | Katy Angelina Medford | Specialist/Technologist | 2000 Pepperell Pkwy, Opelika, AL 36801 | 2020-09-27 |
| 1093321473 | Kelsey Nicole Carter | Registered Nurse | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-09-21 |
| 1881209500 | Monty D Ledbetter | Nurse Practitioner | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-09-10 |
| 1568071652 | Emily Sandlin Norris | Family Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-07-24 |
| 1881219285 | Sarah Vest Cogle | Pharmacist | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-06-11 |
| 1336769892 | Alexa Pratt | Registered Nurse | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-04-24 |
| 1629602339 | Joseph Earl Kaczynski | Nurse Practitioner | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-03-03 |
| 1982235065 | Kimberly De Vincentis Jones | Nurse Anesthetist, Certified Registered | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2020-01-28 |
| 1912541806 | Darlene Wilson | Nurse Practitioner | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2019-11-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407400963 | Paul Simon | Physical Therapist | 3051 Frederick Rd Suite 4, Opelika, AL 36801 | 2019-08-01 |
| 1932662434 | East Alabama Apothecary LLC | Pharmacy | 2501 Village Professional Drive, Suite 2031, Opelika, AL 36801 | 2019-04-11 |
| 1316399108 | Jessica Audrey Haynie | Nurse Practitioner | 2609 Village Prof. Dr., Suite 3, Opelika, AL 36801 | 2016-07-06 |
| 1639574916 | Melissa Shah Kerber | Dentist | 2015 Interstate Drive, Opelika, AL 36801 | 2014-10-28 |
| 1588096200 | Carla Lynn Hudson | Nurse Practitioner | 2420 Village Professional Drive, Opelika, AL 36801 | 2013-08-05 |
| 1528404878 | Baowu Wang | Psychiatry & Neurology | 2506 Lambert Drive, Opelika, AL 36801 | 2013-05-14 |
| 1144566266 | Caremed Inc. | Durable Medical Equipment & Medical Supplies | 702 N Railroad Ave., Opelika, AL 36801 | 2012-12-18 |
| 1659635472 | Meshia Kerry-ann Wallace | Internal Medicine | 2412 Village Professional Dr S, Opelika, AL 36801 | 2012-06-26 |
| 1558651570 | Amanda Mamie Reimer | Psychiatry & Neurology | 2570 Village Professional Park, Opelika, AL 36801 | 2011-04-11 |
| 1356640569 | Mary Neal Gipson | Marriage & Family Therapist | 218 S. 8th St., Opeika, AL 36801 | 2011-03-28 |
| Find all providers in zip 36801 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659541670 | Eamc Er Physicians | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2008-03-05 |
| 1629120712 | Emergency Medicine South | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2007-01-17 |
| 1154388783 | Ricky L Ledkins | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-27 |
| 1649236720 | James D Crosby | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-26 |
| 1750347845 | Robert N Leach Jr. | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-26 |
| 1922064989 | John H Mcfarland | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-26 |
| 1598721565 | Alan L Moore | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-26 |
| 1184680472 | Kim J Williams | Emergency Medicine | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740642180 | Derek Hunt | Emergency Medicine | 709 Sugar Bend Cir Sw, Madison, AL 35756-5311 | 2016-03-24 |
| 1740595362 | Thomas Kenyon Rose | Emergency Medicine | 130 Aniska Dr, Gadsden, AL 35901-9133 | 2010-08-09 |
| 1871706960 | Eric Wallace | Emergency Medicine | Paula Bldg 230, 728 Richard Arrington Blvd, Birmingham, AL 35294-0001 | 2007-05-07 |
| 1275610602 | Nilam Chiman Patel | Emergency Medicine | 2427 Glasscott Pt, Hoover, AL 35226-6323 | 2006-11-01 |
| 1306922380 | Russell Lee Page II | Emergency Medicine | 25273 Fifth Ave, Florala, AL 36422 | 2006-10-31 |
| 1518981174 | Simmons Ambulance Service | Emergency Medicine | 1956 Sawyer Dr, Monroeville, AL 36460-7984 | 2006-07-27 |
| 1205803327 | D'livro Lemat Beauchamp | Emergency Medicine | 4705 Woodmere Blvd, Montgomery, AL 36106-3078 | 2006-03-07 |
| 1740277607 | Adam Ross Nortick | Emergency Medicine | 339 Walker Chapel Plz Ste 115, Fultondale, AL 35068-3402 | 2005-10-05 |
| 1750980819 | Ivy Creek Specialty Care | Emergency Medicine | 201 Mariarden Rd, Dadeville, AL 36853-6244 | 2020-10-20 |
| 1396342184 | Ivy Creek Specialty Care | Emergency Medicine | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2020-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.