Dirne Health Centers Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

DIRNE HEALTH CENTERS INC

Doing business as

Heritage Health

Practice address

1090 W Park PL Ste B
Coeur D Alene, ID 83814-2785

Phone

(208) 292-0697

Fax

(208) 292-0357

NPI assigned

Jul 18, 2018

Last updated

May 5, 2022By 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

Michael Baker

Title

Ceo

Phone

(208) 620-5200

Specialties & licenses 15

Addresses

Other names 1

• Heritage Health Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1720564271. Details of each certification follow.

• CCN 131849 Federally qualified health center · Active · Name & address match · Details
• CCN 131881 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 131849

Legal name

DIRNE CHC UGM CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 4, 2013

Last certification

Mar 4, 2013

Ownership / control type

Non-profit – corporation

Facility address

196 W Haycraft Avenue
Coeur D Alene, ID 83815

Federally qualified health center certification: CCN 131881

Legal name

HERITAGE HEALTH CHILDREN AND FAMILY SERVICES

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 16, 2019

Last certification

Oct 16, 2019

Ownership / control type

For profit – partnership

Facility address

6795 N Mineral Dr
Coeur D Alene, ID 83815

Locations

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua M Behrens

  • Community Health Worker
  • Coeur d'Alene, ID
  • NPI 1851648059
  NPD (past)
• Sarah Jean Bjorn, LCSW

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1659819878

  Mental Health

  NPD (past)
• Scott Andrew Burke, LCSW

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1972996924

  Mental Health

  NPD (past)
• Deborah Christina Carder, LCSW-42229

  • Social Worker
  • Coeur d'Alene, ID
  • NPI 1487131017
  NPD (past)
• Mellisa Ann Carlson, LCSW

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1457880825
  NPD (past)
• Kristian Leigh Carson

  • Rehabilitation Practitioner
  • Coeur d'Alene, ID
  • NPI 1811463771
  NPD (past)
• Erica Marie Chaney I, LSW

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1073099719
  NPD (past)
• Luis Esteban Chavolla

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1902372857
  NPD (past)
• Casey L Cinkovich, LCPC

  • Mental Health Counselor
  • Coeur d'Alene, ID
  • NPI 1699142158
  NPD (past)
• Cassey Coleman, CPSS, CFSP

  • Peer Specialist
  • Coeur d'Alene, ID
  • NPI 1962988451
  NPD (past)
• Austin J Cooper, LCSW

  • Clinical Social Worker
  • Coeur d'Alene, ID
  • NPI 1801645403
  NPD (past)
• Timothy Wayne Cork, CPRP, BS

  • Specialist
  • Coeur d'Alene, ID
  • NPI 1174000566
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1720564271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "208-667-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-292-0697",
            "fax_number": "208-292-0357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 E Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838143238",
            "country_code": "US",
            "telephone_number": "208-292-0281",
            "fax_number": "208-666-4122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 W College Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "St Maries",
            "state": "ID",
            "postal_code": "838611822",
            "country_code": "US",
            "telephone_number": "208-245-4363",
            "fax_number": "208-245-4349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16760 N Highway 41",
            "address_purpose": "LOCATION",
            "city": "Rathdrum",
            "state": "ID",
            "postal_code": "838588715",
            "country_code": "US",
            "telephone_number": "208-687-5627",
            "fax_number": "208-687-5628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 E Polston Ave",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838549049",
            "country_code": "US",
            "telephone_number": "208-625-5640",
            "fax_number": "208-625-5641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 McKinley Ave",
            "address_purpose": "LOCATION",
            "city": "Kellogg",
            "state": "ID",
            "postal_code": "838372693",
            "country_code": "US",
            "telephone_number": "208-783-1267",
            "fax_number": "208-786-4471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6795 N Mineral Dr",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838158700",
            "country_code": "US",
            "telephone_number": "208-620-5200",
            "fax_number": "208-667-6547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 W Park Pl Ste B",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142787",
            "country_code": "US",
            "telephone_number": "208-620-5210",
            "fax_number": "208-664-5346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 Ironwood Pl",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142670",
            "country_code": "US",
            "telephone_number": "208-769-4222",
            "fax_number": "208-667-7557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2205 Ironwood Pl Ste A",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142487",
            "country_code": "US",
            "telephone_number": "208-664-8347",
            "fax_number": "208-664-9217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 W Ironwood Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838141402",
            "country_code": "US",
            "telephone_number": "208-620-5210",
            "fax_number": "844-803-7399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 W Park Pl",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142785",
            "country_code": "US",
            "telephone_number": "208-215-2005",
            "fax_number": "208-292-0705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "196 W Haycraft Ave",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838159317",
            "country_code": "US",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIRNE HEALTH CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-620-5200"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Direct Radiology Florida LLC
• Direct Radiology Wisconsin, Service Corporation
• Bret A Dirks, MD
• Dirne Health Centers Inc (Heritage Health)
• Dirne Health Centers Inc (Heritage Health Pharmacy)
• Dirne Health Centers Inc (Heritage Health Pediatrics Coeur d'Alene)
• Dirne Health Centers, Inc (Heritage Health Pharamacy)
• Dirne Health Centers, Inc (Heritage Health Dental)
• Dirne Health Centers, Inc (Heritage Health Homeless Program)
• Dirne Health Centers, Inc. (Heritage Health CFHL CDA)

• Federally Qualified Health Center (FQHC) in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Federally Qualified Health Center (FQHC) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.