Heritage Medical Associates, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-25153 Issued in KS

Legal business name

HERITAGE MEDICAL ASSOCIATES, P.A.

Practice address

500 W 4TH St
Peabody, KS 66866-1103

Phone

(620) 983-2171

Fax

(620) 983-2575

NPI assigned

May 14, 2006

Last updated

Aug 22, 2020By 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

Dr. Randolph Richard Whitely, M.D.

Title

Director

Phone

(620) 983-2171

Specialties & licenses 1

Addresses

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.

• Joseph Black, PA

  • Physician Assistant
  • Wichita, KS
  • NPI 1699784769
  NPD

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

{
    "created_epoch": "1147564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316998305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11881 SW 47TH TER",
            "city": "TOWANDA",
            "state": "KS",
            "postal_code": "671449264",
            "telephone_number": "316-778-2050",
            "fax_number": "316-778-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "PEABODY",
            "state": "KS",
            "postal_code": "668661103",
            "telephone_number": "620-983-2171",
            "fax_number": "620-983-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITELY",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "620-983-2171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-25153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Access Mental Health LLC (Westview Manor of Peabody)
• CK Pharmacies LLC (CK Pharmacy - Peabody)
• CK Pharmacies LLC (CK Pharmacy - Peabody LTC)
• Franklin Healthcare of Peabody, LLC (Westview Manor of Peabody)
• Robert D Hague, DDS
• Gretchen Hind
• Markleysburg Healthcare Investors (Westview Manor of Peabody)
• Sarah McLeod, LMSW
• Medical Center Pharmacy Inc (Dons Rexall Drug)
• Mid-America at Peabody, LLC

• Family Medicine Physician in Peabody, KS
• Providers in Peabody, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.