Heritage Medical House Call

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

12018049 Issued in GA

Legal business name

HERITAGE MEDICAL HOUSE CALL

Practice address

925 Main Street
Suite 300-13
Stone Mountain, GA 30083-3098

Phone

(888) 461-9765

Fax

(678) 381-1684

NPI assigned

Apr 4, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Alexander Lane Sr., PANPI 1821102203

Title

Owner/Member

Phone

(888) 461-9765

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin A Lane Sr., PA-C

  • Physician Assistant
  • New York, NY
  • NPI 1821102203
  NPD Authorized official

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1063778983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 MAIN ST",
            "address_2": "SUITE 300-13",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833098",
            "telephone_number": "888-461-9765",
            "fax_number": "678-381-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 MAIN STREET",
            "address_2": "SUITE 300-13",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833098",
            "telephone_number": "888-461-9765",
            "fax_number": "678-381-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL HOUSE CALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "888-461-9765",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "12018049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124376A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teheran M Height Sr., LMT, NMT
• Hencock Chiropractic LLC (Wellspot Chiropractic)
• Alvin Henderson
• Amber Marie Henry
• Christopher Lamar Herans
• Whitney Hermonstine, LMSW
• William Jordan Herrin
• Jillian Hicks
• Hidden Oasis Counseling LLC
• Kyanna Marie Highsmith

• Home Health Agency in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.