NPIMap

Organization Active NPI

St.Jude Heritage Medical Group

  • Specialist
  • Orange, CA
National Provider Identifier
1972909927
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G86364 Issued in CA
Legal business name
ST.JUDE HERITAGE MEDICAL GROUP
Practice address
1010 W la Veta Ave Ste 710
Orange, CA 92868-4306
Phone
(714) 835-2724
Fax
(714) 835-2753
NPI assigned
Nov 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Mrs. Jacqueline Ramirez
Title
Operations Supervisor
Phone
(714) 835-2724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G86364 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave Ste 710
Orange, CA 92868-4306

Mailing address

1010 W la Veta Ave Ste 710
Orange, CA 92868-4306
Phone (714) 835-2724

National Provider Directory

National Provider Directory
Tax ID family
St Heritage HLTH FNDN44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1972909927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 710",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "714-835-2724",
            "fax_number": "714-835-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 710",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "714-835-2724",
            "fax_number": "714-835-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.JUDE HERITAGE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OPERATIONS SUPERVISOR",
        "authorized_official_telephone_number": "714-835-2724",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G86364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.