CMS-1500 Box 24J / 33a • NPI
1700420288
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367A00000X (CMS 42)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Midwife, Certified Nurse
Box 32 Service Location & ZIP+4
1301 15TH AVE W, WILLISTON, ND, 58801-3821
✓ 9-Digit EDI 837 ZIP+4 (58801-3821)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1700420288 (HEATHER ROSE HASS, MS, CNM, WHNP-BC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1700420288 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | HEATHER ROSE HASS, MS, CNM, WHNP-BC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Midwife, Certified Nurse NUCC Code: 367A00000X (Advanced Practice Midwife) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1301 15TH AVE W, WILLISTON, ND, 58801-3821 |
| Practice Telephone / Fax | Tel: (701) 572-7651 |
| Administrative Mailing Address | 412 11TH AVE W, RAY, ND, 58849-3005 |
| Enumeration & Last Sync | Enumerated: 2019-10-29 | CMS Record Updated: 2019-10-29 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (367A00000X)
What Does Taxonomy Code 367A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Midwife, Certified Nurse"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HEATHER ROSE HASS, MS, CNM, WHNP-BC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LW0102X — Nurse Practitioner, Women's HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Women’s Health | State: ND | License: R35617 | Primary: Secondary |
367A00000X — Advanced Practice MidwifePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Midwife, Certified Nurse | State: ND | License: R35617 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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