Individual provider Active NPI

Heather Renee Branch, FNP

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1144732983
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135150 Issued in TX
Practice address
7104 New Sanger Rd
Waco, TX 76712-3928
Phone
(254) 537-6270
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135150 TX Primary

Addresses

Primary practice location

7104 New Sanger Rd
Waco, TX 76712-3928

Mailing address

7104 New Sanger Rd
Waco, TX 76712-3928
Phone (254) 537-6270

Other names 1

  • Heather Shaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171201001508 TX Practitioner - Nurse Practitioner 7416214341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

2100 Lake Shore Dr
Waco, TX 76708-1271
Phone (254) 537-6160

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

340 Richland W Cir
Ascension Medical Group Providence
Waco, TX 76712-7919
Phone (254) 537-6050

342 Richland W Cir
Waco, TX 76712-7919
Phone (254) 537-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP135150TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Dec 1, 2017 Accepting new patients
Premier Physicians-II, P.a. CurrentSince May 26, 2019 Accepting new patients
Providence Health Alliance CurrentSince Dec 1, 2017 Accepting new patients

Locations

2100 Lake Shore Dr
Waco, TX 76708
Phone (254) 537-6160

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

900 Austin Ave
Ste 1001
Waco, TX 76701
Phone (254) 224-8808

7104 Sanger Rd
Woodway, TX 76712
Phone (254) 262-3188

Interoperability endpoints

  • Direct secure messaging: heather.branch.1@9635.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1144732983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7104 NEW SANGER RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123928",
            "telephone_number": "254-537-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7104 NEW SANGER RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123928",
            "telephone_number": "254-537-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "SHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.