Individual provider Active NPI

Heather Kathleen Connell

  • Health Information Technician
  • Medford, OR
National Provider Identifier
1912563008
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Information TechnicianTaxonomy code 247000000X
Practice address
300 W Main St
Medford, OR 97501-2756
Phone
(541) 772-1777
NPI assigned
May 14, 2019
Last updated
May 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Information Technician 247000000X NU Primary
Community Health Worker 172V00000X NU

Addresses

Primary practice location

300 W Main St
Medford, OR 97501-2756

Mailing address

300 W Main St
Medford, OR 97501-2756
Phone (541) 772-1777

Other practice location 1

2301 Cove Ave
LA Grande, OR 97850-3906
Phone (541) 962-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ontrack, Inc. PastSince May 16, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1912563008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012756",
            "telephone_number": "541-772-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012756",
            "telephone_number": "541-772-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Cove Ave",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978503906",
            "country_code": "US",
            "telephone_number": "541-962-8811",
            "fax_number": "541-963-5272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "HEATHER",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.