NPIMap

Organization Active NPI

Heritage Direct Care, LLC

  • Family Medicine Physician
  • Windsor, CT
National Provider Identifier
1174996706
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
028638 Issued in CT
Legal business name
HERITAGE DIRECT CARE, LLC
Practice address
61 Bloomfield Ave
Windsor, CT 06095-2809
Phone
(860) 687-5722
NPI assigned
Nov 4, 2015
Last updated
Nov 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Dr. Jane Inman Walker, M.D.NPI 1679762033
Title
Member
Phone
(860) 874-5722

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 028638 CT Primary

Addresses

Primary practice location

61 Bloomfield Ave
Windsor, CT 06095-2809

Mailing address

61 Bloomfield Ave
Windsor, CT 06095-2809
Phone (860) 687-5722

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1174996706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BLOOMFIELD AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952809",
            "telephone_number": "860-687-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BLOOMFIELD AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952809",
            "telephone_number": "860-687-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE DIRECT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "INMAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-874-5722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "028638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.