Individual provider Active NPI

Heenaben Rathod, FNP

  • Nurse Practitioner
  • Live Oak, TX
National Provider Identifier
1417566548
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1010971 Issued in TX
Practice address
12410 Toepperwein Rd
Live Oak, TX 78233-3230
Phone
(210) 742-6555
Fax
(224) 623-0079
NPI assigned
Jul 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 979120 TX
Registered Nurse 163W00000X 041.458859 IL
Nurse Practitioner 363L00000X 1010971 TX Primary

Addresses

Primary practice location

12410 Toepperwein Rd
Live Oak, TX 78233-3230

Mailing address

12410 Toepperwein Rd
Live Oak, TX 78233-3230
Phone (210) 742-6555

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
I20211028000560 TX Practitioner - Nurse Practitioner 5799173506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

1351 W 43Rd St
Houston, TX 77018-4205
Phone (346) 398-7218

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.458859ILMDRegistered Nurse
979120TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Practice, L.L.P CurrentSince Jan 20, 2022 Accepting new patients
Heal Well Primary Care PC CurrentSince Mar 26, 2023 Accepting new patients
Villagemd of Southeast Texas, PA Nurse Practitioner CurrentSince Jan 20, 2022 Accepting new patients

Locations

1351 W 43rd St
Houston, TX 77018
Phone (346) 398-7218

600 N Shepherd Dr
Ste 530
Houston, TX 77007
Phone (713) 496-9179

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

12410 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 659-4425

12410 Toepperwein Rd
#O
Live Oak, TX 78233
Phone (210) 659-4425

Interoperability endpoints

  • Direct secure messaging: heena.rathod.1@13711.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1417566548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555",
            "fax_number": "224-623-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555",
            "fax_number": "224-623-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHOD",
        "first_name": "HEENABEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "979120",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.458859",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1010971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.