Individual provider Active NPI

Heather Rivera Gutekunst, MD

  • Allergy & Immunology Physician
  • Raleigh, NC
National Provider Identifier
1720247646
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
2008-00939 Issued in NC
Practice address
10880 Durant Rd
Suite 200
Raleigh, NC 27614-6628
Phone
(919) 846-0800
Fax
(919) 846-0880
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 200800939 NC
Allergy & Immunology Physician 207K00000X 2008-00939 NC Primary

Addresses

Primary practice location

10880 Durant Rd
Suite 200
Raleigh, NC 27614-6628

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
1720247646MedicaidNC
NC0584BOtherNCMEDICARE PTAN

Other names 1

  • Heather Marie Rivera Former name

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
I20100730000975 NC Practitioner - Internal MedicinePractitioner - Allergy/Immunology 7012040868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Allergy/Immunology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

3600 NW Cary Pkwy
Suite 102
Cary, NC 27513-8444
Phone (919) 846-0800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200800939NCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Sep 9, 2013 Accepting new patients
NPI 1508468638 Allergy & Immunology CurrentSince Sep 9, 2013 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Past Accepting new patients

Locations

3600 NW Cary Pkwy
Ste 102
Cary, NC 27513
Phone (919) 846-0800

10880 Durant Rd
Ste 200
Raleigh, NC 27614
Phone (919) 295-6661

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1720247646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10880 DURANT RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146628",
            "telephone_number": "919-846-0800",
            "fax_number": "919-846-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTEKUNST",
        "first_name": "HEATHER",
        "middle_name": "RIVERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "200800939",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "2008-00939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720247646",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC0584B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "RIVERA",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.