Heartland Personal Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

PCA48198920150915 Issued in MN

Legal business name

HEARTLAND PERSONAL HOME CARE LLC

Practice address

2219 Chicago Ave
Minneapolis, MN 55404-3842

Phone

(612) 239-9968

NPI assigned

Sep 18, 2015

Last updated

Sep 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason Andrew Rodgers

Title

President

Phone

(612) 239-9968

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1699144782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043842",
            "telephone_number": "612-239-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043842",
            "telephone_number": "612-239-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND PERSONAL HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-239-9968",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MN",
            "license": "PCA48198920150915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA DEPARTMENT OF HUMAN SERVICES",
            "identifier": "PCA48198920150915",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.