HERITAGE OBGYN (NPI# 1285902197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285902197 |
| Entity Type | Organization |
| Organization Name | HERITAGE OBGYN |
| Practice Address |
2695 Old Winder Hwy Ste 250 Braselton GA 30517-6075 |
| Mailing Address |
668 Lanier Park Dr Gainesville GA 30501-2061 |
| Practice Telephone | 7709654170 |
| Practice Fax Number | 7709654171 |
| Mailing Telephone | 7705311515 |
| Mailing Fax Number | 7705311930 |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |
| Authorized Official Name | ANNETTE SLOAN (ADMINISTRATOR) |
| Authorized Official Telephone | 7705311515 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE OBGYN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
2695 OLD WINDER HWY STE 250 |
| City | BRASELTON |
| State | GA |
| Zip Code | 30517-6075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497802375 | Joseph A Greco IIi | Plastic Surgery | 2695 Old Winder Hwy, Ste 150, Braselton, GA 30517-6075 | 2007-01-04 |
| 1316237621 | Greco Aesthetics LLC | Plastic Surgery | 2695 Old Winder Hwy, Ste 150, Braselton, GA 30517-0000 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904076 | Northeast Georgia Dental Group | Dentist | 1205 Friendship Road, Braselton, GA 30517 | 2018-06-05 |
| 1548772544 | Shaniqua Lynee Sims | Nurse Practitioner | 1515 River Pl Ste 280, Braselton, GA 30517 | 2017-10-30 |
| 1538671847 | Georgia Pain and Wellness Center | Durable Medical Equipment & Medical Supplies | 1255 Frienship Road, Suite 150, Braselton, GA 30517 | 2017-10-26 |
| 1295137735 | Connie Johnson | Occupational Therapy Assistant | 5373 Thompsons Mill Rd., Braselton, GA 30517 | 2014-09-16 |
| 1780970921 | Christopher Thomas Middendorf | Hospitalist | 1400 River Place, Braselton, GA 30517 | 2011-06-27 |
| 1407140999 | Ashley Williams Zimmerman | Registered Nurse | 1515 River Pl Ste 340, Braselton, GA 30517 | 2011-06-02 |
| 1891097382 | Thu Mong Tran Nguyen | Dentist | 1702 Ammon Falls Ct, Braselton, GA 30517 | 2010-12-03 |
| 1053436030 | Andrew L Tam | Dentist | 5122 Hwy 53, Braselton, GA 30517 | 2007-03-20 |
| 1871503987 | Kathy Baxendale Morse | Nurse Practitioner | 2695 Old Winder Hwy, Suite 200, Pediatric Associates, Braselton, GA 30517 | 2006-08-09 |
| 1073585782 | Champak Patel | Legal Medicine | 5196 Hwy 53, Braselton, GA 30517 | 2006-02-06 |
| Find all providers in zip 30517 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619949039 | David Holt Harrison | Obstetrics & Gynecology | 1404 River Pl Ste 303, Braselton, GA 30517-5600 | 2006-02-02 |
| 1477973972 | Jeremy Grant | Obstetrics & Gynecology | 1400 River Pl, Braselton, GA 30517-5600 | 2014-04-23 |
| 1811287360 | Kimberly Michell Barrett | Obstetrics & Gynecology | 1404 River Pl Ste 303, Braselton, GA 30517-5600 | 2011-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639794001 | Stephanie Stokes | Obstetrics & Gynecology | 1120 15th St Ste Ba-7300, Augusta, GA 30912-0004 | 2020-06-11 |
| 1346865839 | Teodora Stoikov | Obstetrics & Gynecology | 1120 15th St # Ba-7411, Augusta, GA 30912-0004 | 2020-06-10 |
| 1477185221 | Metro Health and Wellness, LLC | Obstetrics & Gynecology | 2950 Stone Hogan Connector Rd Sw Bldg B, Atlanta, GA 30331-2837 | 2020-02-10 |
| 1437707783 | One Health Research Clinic Atlanta LLC | Obstetrics & Gynecology | 5880 Live Oak Pkwy Ste 160, Norcross, GA 30093-1742 | 2019-08-29 |
| 1528627650 | Suellen Anizia Romero De Mello Sa | Obstetrics & Gynecology | 1120 15th St # Ba-7310, Augusta, GA 30912-0004 | 2019-06-12 |
| 1457910069 | Taylor Mitchell Jones | Obstetrics & Gynecology | 1120 15th St # Ba-7300, Augusta, GA 30912-3300 | 2019-06-07 |
| 1871156687 | Alexandra Poch | Obstetrics & Gynecology | 1120 15th St # Ba7300, Augusta, GA 30912-0004 | 2019-04-17 |
| 1912485830 | Hilton Head Regional Physician Network - Georgia, LLC | Obstetrics & Gynecology | 1000 Towne Center Blvd Ste 604b, Pooler, GA 31322-4052 | 2018-08-02 |
| 1003302852 | Louis Wayne Goolsby | Obstetrics & Gynecology | 6605 Britt Rd, Macon, GA 31216-6031 | 2018-07-05 |
| 1508356395 | Hospital Authority of Liberty County | Obstetrics & Gynecology | 455 S Main St Ste 202, Hinesville, GA 31313-4354 | 2018-05-16 |
| Find all providers with the same taxonomy | ||||
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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.