HEATHER HADDOCK (NP) – Family Nurse Practitioner, NPI 1003688474

HEATHER HADDOCK (NP) is a healthcare provider. based in Dyersburg, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 34970 (TN). The NPI Number for HEATHER HADDOCK (NP) is 1003688474

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER HADDOCK (NP)
NPI
1003688474
Phone
(731) 285-9938
Address
1718 PARR AVE STE E
Enumeration Date
27 October 2023
Last Update Date
31 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7312645555
Graduation Year
2023 (3 years ago)
PAC ID
0648620575
Group Practice PAC ID
1951487826
Professional Enrollment ID
I20231219001001
Address ID
TN380801316RI117XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

10,656 NURSE PRACTITIONER in TN

Provider Addresses for HEATHER HADDOCK (NP)

  • 1718 PARR AVE STE E

    DYERSBURG, TN 380242071

    Phone: (731) 285-9938

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231219001001INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 38024)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951487826View full group profile
NameSpecialtyState
-TN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerKY
Nurse PractitionerTN

Reviews

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Frequently asked questions

Does HEATHER HADDOCK (NP) have a public NPI I can cite?
Public records show HEATHER HADDOCK (NP) under NPI 1003688474.
Does the public listing show HEATHER HADDOCK (NP) as active?
HEATHER HADDOCK (NP)'s NPI record reflects an active status in NPPES.
How should patients interpret HEATHER HADDOCK (NP)'s specialty?
The extract shows Family Nurse Practitioner for HEATHER HADDOCK (NP). Clinical services aligned with this taxonomy classification.
Which community is linked to HEATHER HADDOCK (NP)?
HEATHER HADDOCK (NP) shows a connection to Dyersburg, Tennessee in registry-derived data.
Who maintains HEATHER HADDOCK (NP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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