Organization Active NPI

Heritage Parkway Medical PLLC

Doing business as Diverse Care

  • Family Medicine Physician
  • Sherman, TX
National Provider Identifier
1770140550
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE PARKWAY MEDICAL PLLC
Doing business as
Diverse Care
Practice address
3415 North Heritage Parkway
Sherman, TX 75092-6634
Phone
(903) 308-4336
Fax
(214) 305-9078
NPI assigned
May 28, 2019
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Nidish Jose, AGNPNPI 1104348903
Title
Ceo
Phone
(903) 308-4336

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3415 North Heritage Parkway
Sherman, TX 75092-6634

Mailing address

2410 Luna Rd Ste 202
Carrollton, TX 75006-6538
Phone (903) 308-4336

Other practice location 1

2709 Cimarron Blvd Ste 100
Corpus Christi, TX 78414-3431
Phone (361) 208-7276

Other practice location 2

2410 Luna Rd Ste 202
Carrollton, TX 75006-6538
Phone (214) 592-1854

Other names 1

  • Diverse Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190709002032 TX Part B Supplier - Clinic/Group Practice 0547595852 Receives reassigned benefits from 5 practitioners
Practice locations: San Antonio, TX; Sherman, TX; Corpus Christi, TX; Carrollton, TX; Canton, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2167651Heritage Parkway Medical, PLLC3415 N Heritage Parkway, Sherman, TX 75092Certificate of waiverJun 11, 2027

National Provider Directory

National Provider Directory

Locations

658 S Trade Days Blvd
Canton, TX 75103
Phone (469) 844-7021

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1770140550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 LUNA RD STE 202",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066538",
            "telephone_number": "903-308-4336",
            "fax_number": "903-771-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 NORTH HERITAGE PARKWAY",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750926634",
            "telephone_number": "903-308-4336",
            "fax_number": "214-305-9078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2709 Cimarron Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784143431",
            "country_code": "US",
            "telephone_number": "361-208-7276",
            "fax_number": "214-305-9078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2410 Luna Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750066538",
            "country_code": "US",
            "telephone_number": "214-592-1854",
            "fax_number": "214-305-9078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HERITAGE PARKWAY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "NIDISH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-308-4336",
        "authorized_official_credential": "AGNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diverse Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.