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HEIDI ROSE BRACKEBUSCH RDN
NPI 1477415982
Dietitian, Registered in Coeur D Alene, ID

Active since December 02, 2025
1765 W GOLF COURSE RD, COEUR D ALENE, ID 83815(208) 277-0795 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 13, 2026, Dec 2, 2025 (2 updates tracked since 2025).

About Heidi Rose Brackebusch Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEIDI ROSE BRACKEBUSCH RDN (NPI 1477415982) is an individual dietitian, registered in Coeur D Alene, Idaho, licensed in Idaho (7671544) and active in the NPI registry since December 2025. She maintains 2 additional practice locations and is a graduate of Other (2023).

NPPES Registry Identity

NPI1477415982
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameHEIDI ROSE BRACKEBUSCHCredential: RDN
Location Address1765 W GOLF COURSE RDCoeur D Alene, ID 83815-9033
Mailing Address1917 N Lakewood DrCoeur D Alene, ID 83814-2634
Phone(208) 277-0795
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateDecember 2, 2025
Last NPPES UpdateMay 13, 20262 updates tracked since enumeration
NPPES CertifiedMay 13, 2026
✔ NPI 1477415982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in ID · 7671544
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1765 W GOLF COURSE RD, Coeur D Alene, ID 83815
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Secondary Practice Locations 2

Location 11610 E Schneidmiller AvePost Falls, ID 83854-7065 · Phone (208) 773-8111
Location 22003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · Phone (208) 625-6664

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heidi Rose Brackebusch Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941778591
PECOS Enrollment IDI20260501002657

Medicare Billing Reassignment

Medicare enrollment records show Heidi Brackebusch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shellman Inc PA
0.9 mi
Physical Therapist
1917 N LAKEWOOD DR
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 49 clinicians in this Medicare group
NPI 1326050253 (208) 664-8194

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLEAR MIND COUNSELING
Clinic/Center (Mental Health (Including Community Mental Health Center))
1765 W GOLF COURSE RD
COEUR D ALENE, ID 83815
Kootenai County (208) 763-0606

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heidi Brackebusch's NPI number?

The NPI number for Heidi Brackebusch is 1477415982. It was assigned to this individual provider in the NPPES registry on December 2, 2025.

Where is Heidi Brackebusch located?

Heidi Brackebusch practices at 1765 W Golf Course Rd, Coeur D Alene, ID 83815. The listed phone number is (208) 277-0795.

What is Heidi Brackebusch's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Heidi Brackebusch enrolled in Medicare?

Yes. Heidi Brackebusch is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Heidi Brackebusch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Heidi Brackebusch reassigns Medicare benefits to Shellman Inc PA (Coeur D Alene, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Heidi Brackebusch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Heidi Brackebusch accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Select Health list Heidi Brackebusch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Heidi Brackebusch was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.