NPIMap

Organization Active NPI

St Joseph Heritage Healthcare

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1770068629
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST JOSEPH HERITAGE HEALTHCARE
Practice address
1 Edwards Way
Irvine, CA 92614-5688
Phone
(949) 250-3737
NPI assigned
Sep 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Authorized official

Name
John Clayton Bennett
Title
Ceo
Phone
(714) 449-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 Edwards Way
Irvine, CA 92614-5688

Mailing address

200 W Center Street Promenade
Anaheim, CA 92805-3960

Other identifiers 1

IdentifierTypeStateIssuer
GR0062055MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
St Heritage HLTH FNDN44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1770068629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W CENTER STREET PROMENADE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDWARDS WAY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145688",
            "telephone_number": "949-250-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HERITAGE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-449-4800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062055",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.