Heritage Manor - Bloomington, LLC
Heritage Manor - Bloomington, LLC is a healthcare organization registered as Oxygen Equipment & Supplies (DME) in Bloomington, IL, holding Type 2 (organization) NPI 1275877979 since 2012. The authorized official on file is David Underwood, Exec Vp, Cfo.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1275877979 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Heritage Manor - Bloomington, LLC |
| Other name | <Unavail> |
| Parent organization | Heritage Enterprises, Inc |
| Practice address | 700 E WALNUT ST, Bloomington, IL, 61701 |
| Phone | 3098278004 |
| Fax | 3098270256 |
| Enumeration date | 2012-11-19 |
| Last updated in NPPES | 2016-10-18 |
Authorized official
| Name | David Underwood |
|---|---|
| Title | Exec Vp, Cfo |
| Phone | 3098237135 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332BX2000X | Oxygen Equipment & Supplies (DME) | Primary | — | — |
Copy-ready billing details
Provider: Heritage Manor - Bloomington, LLC NPI: 1275877979 Taxonomy: 332BX2000X (Oxygen Equipment & Supplies (DME)) Address: 700 E WALNUT ST, Bloomington, IL, 61701
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1457343170 | Heritage Manor Bloomington, LLC | Organization | Skilled Nursing Facility | Bloomington, IL |
| 1780675488 | Heritage Enterprises, Inc. | Organization | Physical Therapist | Bloomington, IL |
| 1801914361 | John Connolly | Individual | Physical Therapist | Bloomington, IL |
| 1669593422 | Edmond Bruce | Individual | Physical Therapist | Bloomington, IL |
| 1316268014 | Renda Watterson | Individual | Occupational Therapy Assistant | Bloomington, IL |
| 1508187204 | Patrick Dagg | Individual | Physical Therapy Assistant | Bloomington, IL |
| 1124462288 | Whitney Harper | Individual | Physical Therapy Assistant | Bloomington, IL |
| 1881038941 | Stephanie Steele | Individual | Occupational Therapy Assistant | Bloomington, IL |
Verify this record
Cross-check NPI 1275877979 against the authoritative CMS record: view Heritage Manor - Bloomington, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Heritage Manor - Bloomington, LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2016-10-18.