Heritage Health Center Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

HERITAGE HEALTH CENTER INC

Practice address

820 E State Highway 88
Jackson, CA 95642-2134

Phone

(209) 223-7040

Fax

(209) 223-7606

NPI assigned

Jan 5, 2024

Organization subpart

No

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

Authorized official

Name

Gary Johnson, MDNPI 1114013513

Title

Ceo

Phone

(209) 223-7040

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 9

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

• Gary Ronald Johnson, M.D.

  • Family Medicine Physician
  • San Andreas, CA
  • NPI 1114013513

  Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Christina Monique Garvin, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jackson, CA
  • NPI 1477840064
  Medicare reassignment Care Compare group NPD
• Cassandra Lee King, FNP-BC

  • Family Nurse Practitioner
  • Jackson, CA
  • NPI 1053185686
  Medicare reassignment Care Compare group NPD
• Gerdy Mirline Pluviose- Aniagu, NP

  • Family Nurse Practitioner
  • Auburn, CA
  • NPI 1285132175
  Medicare reassignment Care Compare group NPD
• Doris W Kamau

  • Registered Nurse
  • Folsom, CA
  • NPI 1457513863
  Medicare reassignment NPD
• Kenneth S Romans, P.A.

  • Physician Assistant
  • San Andreas, CA
  • NPI 1285766600
  Medicare reassignment
• Cailey Dante, PA-C

  • Physician Assistant
  • Jackson, CA
  • NPI 1255090379
  NPD
• Aline B. Nunes, NP

  • Family Nurse Practitioner
  • Jackson, CA
  • NPI 1780447292
  NPD
• Thomas Alan Bowhay, M.D.

  • Family Medicine Physician
  • Jackson, CA
  • NPI 1902919665

  Urgent Care

  NPD (past)

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1801666235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E STATE HIGHWAY 88",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422134",
            "telephone_number": "209-223-7040",
            "fax_number": "209-223-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E STATE HIGHWAY 88",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422134",
            "telephone_number": "209-223-7040",
            "fax_number": "209-223-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-223-7040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Hasson, MD
• Ciara Debra Hawkins, PPS
• Scott A Heatley, M.D.
• Helene Malabed, DO & Terrence C. Turpen, PA-C
• Haley Ann Hemenes, PHARMD
• Stacey Herrera, MA EDS
• Stephanie Hess
• Steven Higgins
• Shannon Hill
• Christy Hobgood

• Urgent Care Clinic/Center in Jackson, CA
• Providers in Jackson, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.