Heritage Home Health, LLC

Organization Active NPI Community Based Hospice Care Agency · Pocatello, ID

NPI 1629319280 · NPPES record last updated Apr 24, 2026

Key facts

NPI
1629319280
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
Legal business name
HERITAGE HOME HEALTH, LLC
Practice address
1009 W Quinn Rd
Suite B
Pocatello, ID 83202-2425
Phone
(208) 238-0088
Fax
(208) 238-0055
NPI assigned
Mar 7, 2013
Organization subpart
No

Authorized official

Name
Jonny Ryan Fisher
Title
Ceo
Phone
(208) 238-0088

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Heritage Hospice CCN 131568
Ownership
For-Profit
Certified
Aug 12, 2013
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Hospice certification: CCN 131568

Legal name
HERITAGE HOME HEALTH LLC
Doing business as
HERITAGE HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 12, 2013
Last certification
Jun 22, 2017
Ownership / control type
Proprietary - Partnership
Organization structure
LLC · Proprietary
Enrollment address
1009 W Quinn Rd
Pocatello, ID 83202-2425

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jonathan Fisher
Individual
5% Or Greater Indirect Ownership Interest Aug 31, 2023 21.48%
Corporate Officer
Ceo
Aug 31, 2023 21.48%
Kellen B Fisher
Individual
5% Or Greater Indirect Ownership Interest Aug 31, 2023 8.05%
Corporate Officer
Member/Owner
Aug 31, 2023 8.05%
Kimberly Hymas
Individual
Contracted Managing Employee
Ad;
Sep 1, 2024
Blackline Financial LLC
Organization · Chubbuck, ID
LLC, Owned by another organization or individual
5% Or Greater Direct Ownership Interest Aug 31, 2023 21.48%
Operational/Managerial Control Aug 31, 2023 21.48%
Ipm LLC
Organization · Pocatello, ID
LLC, Owned by another organization or individual
5% Or Greater Direct Ownership Interest Aug 31, 2023 8.05%
Troy V Bell
Individual
5% Or Greater Direct Ownership Interest Aug 31, 2023 70.46%
Corporate Officer
Member/Owner
Aug 31, 2023 70.46%
Operational/Managerial Control
Member/Owner
Aug 31, 2023 70.46%
Zachary B Warnock
Individual
Contracted Managing Employee
MD;
Apr 24, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130402000243 ID Part a Provider - Hospice 5092856773 Practice locations: Twin Falls, ID; Pocatello, ID; Idaho Falls, ID

National Provider Directory

Tax ID family
Heritage Health (2 organizations share this tax ID)

Locations

1075 S Utah Ave
Ste 319
Idaho Falls, ID 83402
Phone (208) 980-6342

1460 Chamberlain Ave
Idaho Falls, ID 83402
Phone (208) 238-0088

4922 Yellowstone Ave
Ste J
Pocatello, ID 83202
Phone (208) 237-1882

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16899/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Yes

Addresses

Primary practice location

1009 W Quinn Rd
Suite B
Pocatello, ID 83202-2425

Mailing address

1009 W Quinn Rd
Suite B
Pocatello, ID 83202-2425
Phone (208) 238-0088

Other practice location 1

560 W Sunnyside Rd Ste E
Idaho Falls, ID 83402-4521
Phone (208) 980-6342

Other practice location 2

788 Eastland Dr Ste A
Twin Falls, ID 83301-6856
Phone (208) 410-4040

Other names

  • Heritage Hospice Doing business as

Other providers in Pocatello, ID

All providers in Pocatello, ID · Community Based Hospice Care Agency in Idaho

Sources for this page

Verify at the official NPI Registry.