NPIMap

Organization Active NPI

Heritage Family Physicians

Doing business as Health Pavilion Family Care

  • Family Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1003818485
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE FAMILY PHYSICIANS
Doing business as
Health Pavilion Family Care
Practice address
6387 Ramsey St Unit 210
Fayetteville, NC 28311-9442
Phone
(910) 615-3920
Fax
(910) 321-6221
NPI assigned
Aug 15, 2005
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Fiser
Title
Executive Director
Phone
(910) 615-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6387 Ramsey St Unit 210
Fayetteville, NC 28311-9442

Mailing address

1638 Owen Drive
Attn: Managed Care Planning
Fayetteville, NC 28304
Phone (910) 615-6949

Other names 1

  • Health Pavilion Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041004000352 NC Part B Supplier - Clinic/Group Practice 5193784494 Receives reassigned benefits from 5 practitioners
Practice locations: Fayetteville, NC

National Provider Directory

National Provider Directory
Tax ID family
Melrose Pediatric Care50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1262 Oliver St
Ste A
Fayetteville, NC 28304
Phone (910) 323-2503

5107 College Center Dr
Fayetteville, NC 28311
Phone (336) 970-3943

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1003818485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DRIVE",
            "address_2": "ATTN: MANAGED CARE PLANNING",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-615-6949",
            "fax_number": "910-615-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 RAMSEY ST UNIT 210",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119442",
            "telephone_number": "910-615-3920",
            "fax_number": "910-321-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE FAMILY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "FISER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-615-5572"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Pavilion Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health Pavilion Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.