Heritage Medical Group, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

51703 Issued in GA

Legal business name

HERITAGE MEDICAL GROUP, PC

Practice address

1010 Pennsylvania Avenue
Heritage Medical Group, PC
McDonough, GA 30253

Phone

(770) 288-3883

Fax

(770) 288-3885

NPI assigned

Jan 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Oladayo Adisa Osinuga, MD

Title

Medical Director/Owner

Phone

(770) 288-3883

Specialties & licenses 3

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Akinwole A Awujo, MD

  • Hematology & Oncology Physician
  • Riverdale, GA
  • NPI 1780629519
  NPD (past)
• Ophelia A Botah-Oduro, DNP, FNP-C

  • Family Nurse Practitioner
  • Stockbridge, GA
  • NPI 1982899761
  NPD (past)
• Divina N Dyer, MD

  • Family Medicine Physician
  • Carrollton, GA
  • NPI 1285835769
  NPD (past)
• Mary Teju Guest, M.D.

  • Family Medicine Physician
  • Jbsa Lackland, TX
  • NPI 1740228899
  NPD (past)

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1356526305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PENNSYLVANIA AVENUE",
            "address_2": "HERITAGE MEDICAL GROUP, PC",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "770-288-3883",
            "fax_number": "770-288-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PENNSYLVANIA AVENUE",
            "address_2": "HERITAGE MEDICAL GROUP, PC",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "770-288-3883",
            "fax_number": "770-288-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "OSINUGA",
        "authorized_official_first_name": "OLADAYO",
        "authorized_official_middle_name": "ADISA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "770-288-3883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057161",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "51703",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN178172NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry County Board of Health (Henry County Health Department)
• Henry County Commissioner of Roads and Revenues
• Henry County School System
• Henson and Bidgoly LLLP (Metro Dental Group)
• Heritage Family Practice, LLC
• Heritage Medical Supply LLC
• Sharon Robin Hewlett
• Mary C Hicks, PT
• Highpoint Family Practice, LLC
• Diamond S Hill, PP

• Internal Medicine Physician in McDonough, GA
• Providers in McDonough, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.