Organization Active NPI

Heritage Health LLC

  • Anesthesiology Physician
  • Mableton, GA
National Provider Identifier
1669348488
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
HERITAGE HEALTH LLC
Practice address
5118 Parkwood Oaks LN
Mableton, GA 30126-7603
Phone
(803) 347-5963
NPI assigned
Oct 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Vandy Gaffney, MDNPI 1730470329
Title
Owner
Phone
(803) 347-5963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

5118 Parkwood Oaks LN
Mableton, GA 30126-7603

Mailing address

5118 Parkwood Oaks LN
Mableton, GA 30126-7603
Phone (803) 347-5963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251128000239 GA Part B Supplier - Clinic/Group Practice 3072005958 Receives reassigned benefits from 1 practitioner
Practice locations: Mableton, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1669348488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 PARKWOOD OAKS LN",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267603",
            "telephone_number": "803-347-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 PARKWOOD OAKS LN",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267603",
            "telephone_number": "803-347-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "GAFFNEY",
        "authorized_official_first_name": "VANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-347-5963",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.