Nicole Broadbent Heywood, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA186871 Issued in OR

Practice address

840 SW 4TH Ave Ste 105
Ontario, OR 97914-2638

Phone

(541) 889-2668

Fax

(541) 889-2997

NPI assigned

Dec 1, 2015

Last updated

Jan 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nheywood367466@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Family Health Care, Inc

  dba Valley Family Health Care Women and Children Clinic

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
  • NPI 1295415032
  Medicare reassignment
• Valley Family Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Payette, ID
  • NPI 1407886484
  NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Emmett, ID
  • NPI 1932139995
  NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Nyssa, OR
  • NPI 1083641310
  NPD (past)

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1831564954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "208-642-9376",
            "fax_number": "208-642-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SW 4TH AVE STE 105",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142638",
            "telephone_number": "541-889-2668",
            "fax_number": "541-889-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "NICOLE",
        "middle_name": "BROADBENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1325",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA186871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500750422",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oscar Hernandez
• Grace C. Herrera
• Markus Paola Hess, PHARMD, RPH
• Amber Heyne, CRM, CHW, CADC-R
• James Lee Heyrend, CRNA
• Jim N Hibbard, LMSW
• High Desert Dental
• John Hill
• Kevin T Hill, CADC
• Angela Hillstrom, CADC REGISTRANT

• Physician Assistant in Ontario, OR
• Providers in Ontario, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.