Heritage Medical Providers

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

HERITAGE MEDICAL PROVIDERS

Practice address

10600 Melwood Chapel LN
Upper Marlboro, MD 20772-2960

Phone

(817) 608-7454

NPI assigned

Sep 20, 2024

Organization subpart

No

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

Authorized official

Name

Ayah Taniform

Title

Owner

Phone

(817) 608-7454

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1023835196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MELWOOD CHAPEL LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722960",
            "telephone_number": "817-608-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MELWOOD CHAPEL LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722960",
            "telephone_number": "817-608-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "TANIFORM",
        "authorized_official_first_name": "AYAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-608-7454"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charnae Henry-Smith
• Shanice Henry
• Nija A Hepburn-Nelson, LGPC
• Sacorra Breanna Hepburn
• Anaya D Herbert, RBT
• Jessye Alen Barra Heyrana, LGPC
• Kristi Nicole Hibbert, SLP
• Jasmyne Sade' Hicks, LMSW/LGSW
• Hill-Rom Company, Inc.
• Kayla Hill

• Nurse Practitioner in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.