Heritage Eye Center LC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

000253 Issued in TX

Legal business name

HERITAGE EYE CENTER LC

Doing business as

Heritage Surgery Center LC
Heritage Surgery Center

Practice address

1501-B Redbud Blvd
McKinney, TX 75069

Phone

(972) 548-0771

Fax

(972) 562-2300

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• HERITAGE SURGERY CENTER LC Doing business as
• Heritage Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Heritage Eye Center LCCCN 45C0001092

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/he01zs22

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1205881935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501-B REDBUD BLVD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75069",
            "telephone_number": "972-548-0771",
            "fax_number": "972-562-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501-B REDBUD BLVD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75069",
            "telephone_number": "972-548-0771",
            "fax_number": "972-562-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE EYE CENTER LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "000253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085907601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE SURGERY CENTER LC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Adams Henry, MA, LPA, LSSP
• Christian Antiara Henry, PHD, LPC, NCC
• Torrie Raeshawn Henry
• Ragan Henson, OTR
• Olivia Ann Herber, PT, DPT
• Heritage Lactation
• Heritage Psychiatry PA
• Heritage X-Ray Corporation
• Hermosa Home Visits MHT LLC
• Eugenia Magdalena Hernandez-Moreno

• Ambulatory Surgical Clinic/Center in McKinney, TX
• Providers in McKinney, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.