ELAINE G HEADRICK (NPI# 1336115609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336115609 |
| Entity Type | Individual |
| Full Name | ELAINE G HEADRICK |
| Credential | CNP |
| Practice Address |
911 E. 20th St Ste 200 Sioux Falls SD 57105-1044 |
| Mailing Address |
2400 S. Minnesota Ave Ste 100 Sioux Falls SD 57105-3762 |
| Practice Telephone | 6053223455 |
| Practice Fax Number | 6053223456 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
0271 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0585661 | 05 | |
| MN | UCARE | 140309 | 01 |
| MN | CC SYSTEMS/ BLUE PLUS | 67B26HE | 01 |
| SD | SANFORD HEALTH PLAN | 28563 | 01 |
| SD | MEDICA | 0701587 | 01 |
| SD | PREFERRED ONE | AH1451026885 | 01 |
| SD | HEALTHPARTNERS | HP37108 | 01 |
| SD | BLUE CROSS | 0007481 | 01 |
| SD | DEPT OF LABOR | 370624200 | 01 |
| SD | RR MEDICARE | 500016956 | 01 |
| SD | 6826982 | 05 | |
| SD | ARAZ/ AMERICA'S PPO | 1194219 | 01 |
| SD | WPS TRICARE | 57105E002 | 01 |
| SD | DAKOTACARE | 9240518 | 01 |
| NE | 10025120100 | 05 | |
| SD | MIDLANDS CHOICE | 230278 | 01 |
| MN | 579152900 | 05 | |
| MN | BLUE CROSS | 67B26HE | 01 |
| Street Address |
911 E. 20TH ST STE 200 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962439182 | Michael Allen Person | Surgery | 911 E. 20th St, Ste 700, Sioux Falls, SD 57105-1049 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718187 | Arthur James Pepper | Nurse Practitioner | 1417 S Minnesota Ave, Sioux Falls, SD 57105-1715 | 2013-05-23 |
| 1942572086 | Trichelle Grace Petermann | Nurse Practitioner | 911 E 20th St, Ste 400, Sioux Falls, SD 57105-1042 | 2012-02-06 |
| 1679874242 | Jennifer Louise Reiner | Nurse Practitioner | 1000 E. 23rd St., Ste. 350, Sioux Falls, SD 57105-2113 | 2010-11-12 |
| 1255307450 | Avera Mckennan | Nurse Practitioner | 911 E 20th St, Ste 200, Sioux Falls, SD 57105-1042 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790101905 | Katherine Goulding | Nurse Practitioner | 422 5th Ave Se, Aberdeen, SD 57401-8104 | 2014-03-12 |
| 1740342997 | Donna L. Peters | Nurse Practitioner | 930 N 10th St, Spearfish, SD 57783-2202 | 2006-12-14 |
| 1588993315 | Denise D Carcamo | Nurse Practitioner | 2900 Doolittle Dr, Ellsworth Afb, SD 57706 | 2009-12-07 |
| 1396797502 | Sheri J. Trudeau | Nurse Practitioner | 400 22nd Ave., Brookings, SD 57006-2497 | 2006-05-16 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on ELAINE G HEADRICK.
| 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.