Heritage Birth Center, LLC

Primary specialty

MidwifeTaxonomy code 176B00000X

License

99178 Issued in TX

Legal business name

HERITAGE BIRTH CENTER, LLC

Practice address

3410 Knoxville Ave
Lubbock, TX 79413

Phone

(806) 224-8617

Fax

(806) 329-2632

NPI assigned

Feb 21, 2018

Organization subpart

No

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

Authorized official

Name

Alexandra Wyatt, LM, CPM

Title

Owner

Phone

(818) 421-1355

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Heritage Births Former legal business name

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1194226654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 KNOXVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79413",
            "telephone_number": "806-224-8617",
            "fax_number": "806-329-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 KNOXVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79413",
            "telephone_number": "806-224-8617",
            "fax_number": "806-329-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE BIRTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-421-1355",
        "authorized_official_credential": "LM, CPM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": "TX",
            "license": "99178",
            "primary": true
        },
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "TX",
            "license": "150068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "811042082",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Births",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Twain Michael Henry II, DDS
• Frederick John Hensal, MD
• Sharon Ann Hensley-Barbee, LPC
• Rhealan Hensley, SLP
• Jessica Nicole Hepworth, LMSW
• Sofia Carolina Hernandez Gomez
• Beatriz Hernandez
• Benita Anita Hernandez
• Breanna Noel Hernandez, LCSW
• Christiano Hernandez

• Midwife in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.