NPI age
11 years
Enumerated 2015-03-26
● Active Type 2 · Organization
Heritage Physician And Resource Group Llc
Heritage Physician And Resource Group Llc is 1 of 75 general practice organizations in Idaho.
Primary specialty
General Practice
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Fisher
Ceo
Last NPPES update
2024-08-15
Source: monthly bulk 2026-05
How this organization compares
Across 75 active general practice providers in Idaho.
NPI age
11 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 22% of peers with subspecialties
NPI lifetime · 2015 → 2026
2015-03Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
1009 W Quinn Rd
Pocatello, ID 832022425
Mailing address
1009 W Quinn Rd
Pocatello, ID 832022425
Authorized official
Jonny Ryan Fisher
Ceo
📞 2082380088
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Brandi Cavner, MPT Physical Therapist NPI 1972624781
- Stacey Lewis, COTA/L Occupational Therapy Assistant NPI 1952819237
Specialties
-
General Practice PrimaryA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
-
Social WorkerA social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be...
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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