NPIMap

Organization Active NPI

Healthy Heritage Family Care, LLC.

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1063188118
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHY HERITAGE FAMILY CARE, LLC.
Doing business as
Healthy Heritage Family Care, LLC.
Practice address
40 W Brown Rd Ste 109
Mesa, AZ 85201-3446
Phone
(480) 347-7195
NPI assigned
Aug 18, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nancy Lynn Mitchell, FNP-BCNPI 1043823800
Title
Owner
Phone
(480) 241-2252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

40 W Brown Rd Ste 109
Mesa, AZ 85201-3446

Mailing address

40 W Brown Rd Ste 109
Mesa, AZ 85201-3446
Phone (480) 347-7195

Other names 1

  • Healthy Heritage Family Care, LLC. Doing business as

National Provider Directory

National Provider Directory

Locations

40 W Brown Rd
Ste 109
Mesa, AZ 85201
Phone (480) 241-2252

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1063188118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W BROWN RD STE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013446",
            "telephone_number": "480-347-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W BROWN RD STE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013446",
            "telephone_number": "480-347-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY HERITAGE FAMILY CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-241-2252",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Heritage Family Care, LLC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Heritage Family Care, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.