NPIMap

Organization Active NPI

Heritage Health Center Inc

  • General Practice Physician
  • Poulsbo, WA
National Provider Identifier
1922030444
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
AP30002493 Issued in WA
Legal business name
HERITAGE HEALTH CENTER INC
Practice address
20696 Bond Rd NE
Suite 110
Poulsbo, WA 98370
Phone
(360) 697-5500
Fax
(360) 697-5522
NPI assigned
Jul 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Betty Ann Bennett, ARNPNPI 1831100692
Title
Owner
Phone
(360) 697-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X AP30002493 WA Primary

Addresses

Primary practice location

20696 Bond Rd NE
Suite 110
Poulsbo, WA 98370

Mailing address

20696 Bond Rd NE
Suite 110
Poulsbo, WA 98370
Phone (360) 697-5500

Other identifiers 1

IdentifierTypeStateIssuer
9641366MedicaidWA

Other names 1

  • Betty A Bennett Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922030444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20696 BOND RD NE",
            "address_2": "SUITE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-5500",
            "fax_number": "360-697-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20696 BOND RD NE",
            "address_2": "SUITE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-5500",
            "fax_number": "360-697-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-697-5500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "AP30002493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9641366",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Betty A Bennett",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.