HERITAGE TECHNOLOGIES, LLC (NPI# 1093764938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093764938 |
| Entity Type | Organization |
| Organization Name | HERITAGE TECHNOLOGIES, LLC |
| Other Organization Name | DESERT GROVE FAMILY MEDICAL |
| Practice Address |
840 E Mckellips Rd Ste 101 Mesa AZ 85203-9645 |
| Mailing Address |
Po Box 844776 Dallas TX 75284-4776 |
| Practice Telephone | 4808347546 |
| Practice Fax Number | 4808348001 |
| Mailing Telephone | 4808347546 |
| Mailing Fax Number | 4808348001 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | MICHELLE DINSDALE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 4808347546 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 633795 | 05 |
| Other Name | Type Code |
|---|---|
| Desert Grove Family Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114584208 | Heritage Technologies, LLC | Family Medicine | 1855 N Stapley Dr, Mesa, AZ 85203-3002 | 2019-05-23 |
| Street Address |
840 E MCKELLIPS RD STE 101 |
| City | MESA |
| State | AZ |
| Zip Code | 85203-9645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760444590 | John Graham Boyes | Nurse Practitioner | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2006-04-05 |
| 1922346451 | Carmen Lynn Henry | Family Medicine | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2013-01-17 |
| 1932444304 | Heather Marie Hodnett | Family Medicine | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2012-12-11 |
| 1366769093 | Shivana Devi Naidoo | Psychiatry & Neurology | 840 E Mckellips Rd, Suite 110, Mesa, AZ 85203-9645 | 2010-04-20 |
| 1811219074 | Sheryl Lee Skinner | Nurse Practitioner | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2010-02-15 |
| 1437383874 | Rachel S Erdmann | Nurse Practitioner | 840 E Mckellips Rd, 101, Mesa, AZ 85203-9645 | 2009-05-13 |
| 1194988311 | Rhianna Meadows | Family Medicine | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2008-07-08 |
| 1124299334 | District Medical Group Inc | Psychologist | 840 E Mckellips Rd, Suite #110, Mesa, AZ 85203-9645 | 2008-03-14 |
| 1649291766 | Suzanne Marguerite Payton | Registered Nurse | 840 E Mckellips Rd, Suite 101, Mesa, AZ 85203-9645 | 2006-07-22 |
| 1487617718 | Richard James Dinsdale | Family Medicine | 840 E Mckellips Rd, Suite101, Mesa, AZ 85203-9645 | 2006-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1598251142 | Jonathan Harris | Physician Assistant | 220 N Stapley Dr Ste B, Mesa, AZ 85203 | 2018-07-06 |
| 1316437502 | Arizona's Children Association | Clinic/Center | 1345 E Main St Ste 104, Mesa, AZ 85203 | 2018-05-14 |
| 1922506856 | Hernimarc Durable Medical Equipment | Durable Medical Equipment & Medical Supplies | 1350 E Mckellips Rd Ste 3, Mesa, AZ 85203 | 2018-01-25 |
| 1912411638 | Charles Rudy Wermuth | Surgery | Charles R. Mermuth M.d., 2615 N Barkley, Mesa, AZ 85203 | 2017-11-17 |
| 1841714631 | J. Susanne Davis | Chiropractor | 62 N. Stapley Drive, Mesa, AZ 85203 | 2017-08-02 |
| 1699295329 | Preferred Homecare Infusion LLC | Home Health | 1134 E University Dr Ste 110, Mesa, AZ 85203 | 2017-06-23 |
| 1619407442 | Modern Vascular Institute LLC | Internal Medicine | 535 E Mckellips Rd Ste 115, Mesa, AZ 85203 | 2017-06-14 |
| 1962951632 | Julia A. Gunthner | Counselor | 1528 E. Gary St., Mesa, AZ 85203 | 2016-09-23 |
| 1689121105 | Justine Muntz | Occupational Therapy Assistant | 1304 E. Harvest, Mesa, AZ 85203 | 2016-09-01 |
| Find all providers in zip 85203 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884065 | Miranda Gamgah Njante | Family Medicine | 10445 E Pivitol Ave, Mesa, AZ 85212-8037 | 2020-09-02 |
| 1457987679 | Az Med 4u | Family Medicine | 1136 E Harmony Ave Ste 101, Mesa, AZ 85204-5844 | 2020-03-19 |
| 1619500089 | Elizabeth Lapioli | Family Medicine | 5422 S St Claire, Mesa, AZ 85212-5420 | 2020-02-13 |
| 1003448952 | M.g.t Rn LLC | Family Medicine | 7117 E Peralta Cir, Mesa, AZ 85212-9825 | 2020-02-09 |
| 1144793126 | Health and Wellness Clinic LLC | Family Medicine | 1155 S Country Club Dr, Mesa, AZ 85210-4615 | 2019-01-02 |
| 1013487800 | Akos Live | Family Medicine | 1902 W. Main Street, Mesa, AZ 85201 | 2018-12-05 |
| 1447725189 | Adam Craig Turner | Family Medicine | 925 N Nina Dr, Mesa, AZ 85201-3935 | 2018-10-09 |
| 1235620170 | Stephanie Deborah Kotsur | Family Medicine | 7334 E Plata Ave, Mesa, AZ 85212-9754 | 2018-05-26 |
| 1902308042 | Andrew Jason Wood | Family Medicine | 10902 E Sunland Ave, Mesa, AZ 85208-3938 | 2018-03-05 |
| 1871002683 | Verve Wellness Center, LLC. | Family Medicine | 4838 E Baseline Rd Ste 110, Mesa, AZ 85206-4674 | 2017-09-25 |
| Find all providers in MESA | ||||
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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.