Abide Health & Wellness LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

ABIDE HEALTH & WELLNESS LLC

Practice address

3113 Wesley Way Ste 2
Dothan, AL 36305-2004

Phone

(334) 203-4145

Fax

(334) 245-0335

NPI assigned

Jun 20, 2023

Last updated

Dec 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Juanita Titrud Heersink, MDNPI 1659661874

Title

Medical Director

Phone

(205) 807-6482

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Juanita Titrud Heersink, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Dothan, AL
  • NPI 1659661874
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1144905985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 WESLEY WAY STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052004",
            "telephone_number": "334-203-4145",
            "fax_number": "334-245-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 WESLEY WAY STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052004",
            "telephone_number": "334-203-4145",
            "fax_number": "334-245-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABIDE HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "HEERSINK",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "TITRUD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "205-807-6482",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.