HERITAGE MEDICAL CARE LLC (NPI# 1457438541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457438541 |
| Entity Type | Organization |
| Organization Name | HERITAGE MEDICAL CARE LLC |
| Practice Address |
2160 Fountain Dr Snellville GA 30078-7022 |
| Practice Telephone | 6783776933 |
| Practice Fax Number | 6783776959 |
| Mailing Telephone | 6783776933 |
| Mailing Fax Number | 6783776959 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHUCK LOCKE (VP) |
| Authorized Official Telephone | 6153737600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
2160 FOUNTAIN DR |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078-7022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280551 | Jae H Pak | Psychiatry & Neurology | 2160 Fountain Dr, Suite 200, Snellville, GA 30078-7022 | 2005-07-22 |
| 1326687930 | Joshua Morris | General Acute Care Hospital | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2019-12-30 |
| 1457839219 | Melissa Marie Gray | Nurse Practitioner | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2018-08-03 |
| 1114308475 | Kimberly Schiavoni | Nurse Practitioner | 2160 Fountain Dr, Suite D, Snellville, GA 30078-7022 | 2015-06-12 |
| 1578981130 | Eastside Behavioral Health Associates LLC | Psychiatry & Neurology | 2160 Fountain Dr, Suite 100, Snellville, GA 30078-7022 | 2014-04-01 |
| 1417192360 | Joshua Morris | Psychiatry & Neurology | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2008-12-06 |
| 1235388935 | Robin Matney Boggess | Nurse Practitioner | 2160 Fountain Dr, Suite D, Snellville, GA 30078-7022 | 2008-09-17 |
| 1407069685 | Georgia Psychological Services for Seniors Inc | Clinical Neuropsychologist | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2007-05-07 |
| 1396878500 | Franckel Val Md PC | Psychiatry & Neurology | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2007-03-14 |
| 1134290497 | Frankel Val Md PC | Legal Medicine | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2006-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194176917 | A Baby Consultant, LLC | Specialist | 4168 White Rd, Snellville, GA 30039-4243 | 2016-06-22 |
| 1215365242 | Advanced Urology Anesthesia, LLC | Specialist | 1557 Janmar Rd., Snellville, GA 30078 | 2013-10-30 |
| 1275708786 | Sn Gwinett County Radiation | Specialist | 2094 Mcgee Rd, Snellville, GA 30078-2911 | 2008-04-25 |
| 1306961776 | Theresa Jeanine Mayhue | Specialist | 1860 Tree Brooke Ln, Snellville, GA 30078-6615 | 2007-03-21 |
| 1568452621 | Tracy L Mcelveen | Specialist | 1770 Presidential Cir, Department of Radiation Oncology, Snellville, GA 30078-5643 | 2005-10-28 |
| 1609874726 | Craig M Mines | Specialist | 2121 Fountain Dr, Suite E, Snellville, GA 30078-7023 | 2005-07-12 |
| 1932101102 | Nancy R. Griner | Specialist | 1700 Tree Lane Rd, Ste 320, Snellville, GA 30078-6747 | 2005-06-01 |
| 1528433455 | Auria Medical Clinics, LLC | Specialist | 1700 Tree Ln, Suite 350, Snellville, GA 30078-6782 | 2015-12-03 |
| 1912247628 | Orthoquest P.C. | Specialist | 2336 Wisteria Dr, Suite 430, Snellville, GA 30078-6191 | 2013-02-18 |
| 1134434467 | Gwinnett Orthopedics PC | Specialist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2010-08-11 |
| Find all providers in SNELLVILLE | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.