Provider Demographics
NPI:1447346739
Name:HEIRIGS, RICKY L (MD)
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:L
Last Name:HEIRIGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7440 S 91ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9797
Mailing Address - Country:US
Mailing Address - Phone:402-489-6555
Mailing Address - Fax:402-328-3770
Practice Address - Street 1:102 MCNEEL LN
Practice Address - Street 2:SUITE 1
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6000
Practice Address - Country:US
Practice Address - Phone:308-532-5522
Practice Address - Fax:308-534-7700
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22079207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0714931Medicaid
NE47070592300Medicaid
NE47070592313Medicaid
NE47070592305Medicaid
NE47070592301Medicaid
NE10026072200Medicaid
NE47070592302Medicaid
NE47070592306Medicaid
NE10026072500Medicaid
KS200532160AMedicaid
NE47070592301Medicaid
NEP00238637Medicare PIN
NE279166Medicare PIN
NE47070592306Medicaid
NE47070592300Medicaid
NE10026072500Medicaid
NENA1939031Medicare PIN