Individual provider Active NPI

David Luis Heredia Jr.

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1740742527
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101285589 Issued in VA
Practice address
2139 Auburn Ave Ste 2170
Cincinnati, OH 45219-2989
Phone
(513) 585-4079
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0101285589 VA Primary

Addresses

Primary practice location

2139 Auburn Ave Ste 2170
Cincinnati, OH 45219-2989

Mailing address

2139 Auburn Ave Ste 2170
Cincinnati, OH 45219-2989

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250611000507 VA Practitioner - Internal Medicine 0345575551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2222
Phone (540) 224-4380

101 Elm Ave SE
FL 3
Roanoke, VA 24013-2222
Phone (540) 224-6780

150 Market Ridge LN
Daleville, VA 24083-3258
Phone (540) 966-0400

180 Floyd Ave
Rocky Mount, VA 24151-1318
Phone (540) 483-5277

1906 Belleview Ave SE
Roanoke, VA 24014-1838

2001 Crystal Spring Ave
Suite 205
Roanoke, VA 24014-2462
Phone (540) 985-8505

2001 Crystal Spring Ave SW
Roanoke, VA 24014-2465

2001 Crystal Spring Ave SW
FL 3
Roanoke, VA 24014-2462
Phone (540) 985-8505

2001 Crystal Spring Swave
Roanoke, VA 24014-2465

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

2900 Lamb
700A
Christiansburg, VA 24073-6344
Phone (540) 731-7460

2900 Lamb Cir
Christiansburg, VA 24073-6341

2900 Lamb Cir
Christiansburg, VA 24073-6344
Phone (540) 731-2992

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

415 S Pollard St
Carilion Family Medicine Parkway Physicians
Vinton, VA 24179-2502
Phone (540) 983-6700

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101285589VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 28, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 28, 2025 Accepting new patients
Carilion Medical Center CurrentSince Jul 28, 2025 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jul 28, 2025 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jul 28, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jul 28, 2025 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

2900 Lamb Cir
Ste 201
Christiansburg, VA 24073
Phone (540) 731-2328

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

2001 Crystal Spring Ave SW
Ste 203
Roanoke, VA 24014
Phone (540) 853-0755

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Interoperability endpoints

  • Direct secure messaging: dheredia113384@direct.carilionclinic.org

Organizations & group practices 7

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 9

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1740742527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE STE 2170",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE STE 2170",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192989",
            "telephone_number": "513-585-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "DAVID",
        "middle_name": "LUIS",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101285589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.