HERITAGE INTERNAL MEDICINE, PLLC (NPI# 1457638645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457638645 |
| Entity Type | Organization |
| Organization Name | HERITAGE INTERNAL MEDICINE, PLLC |
| Practice Address |
2824 Rogers Rd Suite 100 Wake Forest NC 27587-3895 |
| Mailing Address |
305 Hidden Lake Dr Youngsville NC 27596-7471 |
| Practice Telephone | 9194350380 |
| Mailing Telephone | 9194350380 |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |
| Authorized Official Name | DR. SOL JIMENEZ GAZZINGAN (MANAGER) |
| Authorized Official Telephone | 9194350380 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 200701946 | NC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5912424 | 05 |
| Street Address |
2824 ROGERS RD SUITE 100 |
| City | WAKE FOREST |
| State | NC |
| Zip Code | 27587-3895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740385061 | Patricia Ann Matheis | Specialist | 2824 Rogers Rd, Suite 101, Wake Forest, NC 27587-3895 | 2006-09-13 |
| 1760094627 | Jennifer Shim | Dentist | 2824 Rogers Rd, Wake Forest, NC 27587-3895 | 2020-08-20 |
| 1063716124 | Brian T. Pressley and Associates, D.d.s, P.a | Dentist | 2824 Rogers Rd, Suite 103, Wake Forest, NC 27587-3895 | 2011-01-04 |
| 1093023053 | Brian Timothy Pressley | Dentist | 2824 Rogers Rd, Suite 103, Wake Forest, NC 27587-3895 | 2010-09-23 |
| 1154565596 | Patricia Matheis, Md, PC | Dermatology | 2824 Rogers Rd, Suite 101, Wake Forest, NC 27587-3895 | 2009-04-29 |
| 1467642082 | Jason T Gladwell D.d,s., P.a. | Dentist | 2824 Rogers Rd, Suite 200, Wake Forest, NC 27587 | 2007-07-30 |
| 1831217363 | Joseph Criscuola | Chiropractor | 2824 Rogers Rd, Suite 204, Wake Forest, NC 27587-3895 | 2007-03-26 |
| 1891848610 | Allen Stuckey Porter | Dentist | 2824 Rogers Rd, Suite 201, Wake Forest, NC 27587-3895 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713080 | Catherine Restrepo | Speech-Language Pathologist | 900 S Franklin St, Ste 201, Wake Forest, NC 27587 | 2020-06-03 |
| 1942760277 | Samantha Fae Pugh | Occupational Therapist | 200 Dr. Calvin Jones Hwy, Suite 200, Wake Forest, NC 27587 | 2019-03-22 |
| 1851863609 | The Counseling Collective | Counselor | 1764 Heritage Center Drive, 204, Wake Forest, NC 27587 | 2018-12-18 |
| 1891270856 | Halston Hoke | Speech-Language Pathologist | 620 Dr. Calvin Jones Hwy Ste 200, Wake Forest, NC 27587 | 2018-09-26 |
| 1710465620 | Amy K Tarnowski | Physical Therapist | The Lodge At Wake Forest, 1151 South Main Street, Wake Forest, NC 27587 | 2018-08-02 |
| 1518452341 | Language and Literacy 365, Pllc | Speech-Language Pathologist | 956 Templeridge Rd, Wake Forest, NC 27587 | 2018-06-25 |
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1124544499 | Carolina Concussion & Physical Medicine, Pllc | Chiropractor | 120 Capcom Aveune, Suite 104, Wake Forest, NC 27587 | 2017-08-18 |
| 1902293889 | Katherine Armine Lorch | Student in an Organized Health Care Education/Training Program | 3000 Rogers Road Ste 210, Wake Forest, NC 27587 | 2015-04-18 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| Find all providers in zip 27587 | ||||
| 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 |
|---|---|---|---|---|
| 1548525090 | Justin J Sullivan | Specialist | 3000 Rogers Rd Ste 110, Wake Forest, NC 27587 | 2012-07-11 |
| 1891012324 | Wake Heart and Vascular Associates P.a. | Specialist | 1966 S Main St, Wake Forest, NC 27587-9336 | 2010-04-23 |
| 1295866580 | Jodi Nicole Whiteman | Specialist | 7224 New Forest Ln, Wake Forest, NC 27587-4988 | 2007-03-08 |
| 1740385061 | Patricia Ann Matheis | Specialist | 2824 Rogers Rd, Suite 101, Wake Forest, NC 27587-3895 | 2006-09-13 |
| 1548234347 | Gina L Micchia | Specialist | 10500 Ligon Mill Rd, Suite 113, Wake Forest, NC 27587-6090 | 2006-02-16 |
| 1740465822 | Hospimed, Pllc | Specialist | 5925 Two Pines Trl, Wake Forest, NC 27587-8461 | 2008-01-08 |
| 1184657298 | Gustavo Vidal | Specialist | 843 Wake Forest Business Park, Suite 110, Wake Forest, NC 27587-6577 | 2006-07-09 |
| 1699749408 | Joseph Matthew Micchia Jr. | Specialist | 10500 Ligon Mill Rd, Suite 113, Wake Forest, NC 27587-6090 | 2006-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989812 | Ryan Graham | Specialist | 405 Avett Dr, Durham, NC 27703-8291 | 2020-07-14 |
| 1184248197 | Tunishia Chanel Parks | Specialist | 106 Daniels Ave, Battleboro, NC 27809-7503 | 2020-06-05 |
| 1306460811 | Ashley Davis | Specialist | 765 Highland Oaks Dr Ste 100, Winston Salem, NC 27103-7100 | 2020-06-01 |
| 1083236996 | Latisha Isheema Buchanan | Specialist | 3215 Guess Rd Ste 101, Durham, NC 27705-2668 | 2020-05-13 |
| 1356962872 | Katherine Joy Griffin | Specialist | 1112 Bottle Brush Ln, Harrisburg, NC 28075-6716 | 2020-05-06 |
| 1174158315 | Shanese Spaulding | Specialist | 309 N Elm St, Lumberton, NC 28358-5649 | 2020-03-09 |
| 1417590290 | Sarah Lyn Granahan | Specialist | 107 Windel Dr Ste 205, Raleigh, NC 27609-4471 | 2019-10-23 |
| 1215580949 | Felisha Cheadle | Specialist | 240 Appalachian Dr, Raeford, NC 28376-6342 | 2019-07-22 |
| 1962062240 | Shenika Twanet Judd | Specialist | 724 N Reilly Rd Ste C, Fayetteville, NC 28303-6042 | 2019-06-18 |
| 1033676358 | Suzanne Lynn Washburn | Specialist | 307 Barcelona Drive 26e, Fayetteville, NC 28303-5768 | 2019-02-22 |
| Find all providers with the same taxonomy | ||||
| City | WAKE FOREST |
| Zip Code | 27587 |
Please comment or provide details below to improve the information on HERITAGE INTERNAL MEDICINE, PLLC.
| 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.