Individual provider Active NPI

Richard Eric Huettemann Jr., MD

  • Colon & Rectal Surgery Physician
  • Clemmons, NC
National Provider Identifier
1255824041
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
2024-02222 Issued in NC
Practice address
7210 Village Medical Cir Ste 310
Clemmons, NC 27012-8041
Phone
(336) 277-4075
Fax
(336) 277-4070
NPI assigned
Jun 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2024-02222 NC
Surgery Physician 208600000X LL52558 SC
Colon & Rectal Surgery Physician 208C00000X 2024-02222 NC Primary

Addresses

Primary practice location

7210 Village Medical Cir Ste 310
Clemmons, NC 27012-8041

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-0100
Phone (843) 792-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905000273 NC Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8022361708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
NMG Health Services LLCGroup PAC ID 4789057753, 40 clinicians

Practice addresses (Care Compare)

330 Billingsley Rd
Suite 202
Charlotte, NC 28211-5020
Phone (704) 316-2350

770 Highland Oaks Dr
Suite 100
Winston Salem, NC 27103-7105
Phone (336) 718-1970

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL52558SCMDSurgery Physician
2024-02222NCMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Surgery CurrentSince Aug 8, 2024 Accepting new patients
NMG Health Services, LLC CurrentSince Dec 14, 2025 Accepting new patients
NMG Health Services LLC CurrentSince Dec 14, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 8, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

6331 Carmel Rd
Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

7210 Village Medical Cir
Ste 310
Clemmons, NC 27012
Phone (336) 277-4075

14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265

1471 Jag Branch Blvd
Unit 105
Kernersville, NC 27284
Phone (336) 277-4075

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

770 Highland Oaks Dr
#100
Winston Salem, NC 27103
Phone (336) 718-1970

Interoperability endpoints

  • Direct secure messaging: rhuettemann253395@direct.bilh.masshiway.net
  • Direct secure messaging: rhuettemann1576378@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1255824041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 VILLAGE MEDICAL CIR STE 310",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128041",
            "telephone_number": "336-277-4075",
            "fax_number": "336-277-4070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294250100",
            "country_code": "US",
            "telephone_number": "843-792-3072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUETTEMANN",
        "first_name": "RICHARD",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2024-02222",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL52558",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "2024-02222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.