Med One Medical Group

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

9300076 Issued in NC

Legal business name

MED ONE MEDICAL GROUP

Practice address

7019 Harps Mill Rd
Suite 200
Raleigh, NC 27615-3248

Phone

(919) 850-1300

NPI assigned

Apr 30, 2014

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Med One Medical Group3 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Med One

  • Primary Care Clinic/Center
  • Raleigh, NC
  • NPI 1093146177
  NPD tax ID
• Med One Medical Group

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1548346331
  NPD tax ID

Practitioners 1

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

• Gary Gruber, D.C.

  • Chiropractor
  • Raleigh, NC
  • NPI 1558305060
  NPD (past)

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1841600749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7019 HARPS MILL RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153248",
            "telephone_number": "919-850-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED ONE MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NC",
            "license": "9300076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med First Immediate Care & Family Practice, PA
• Med First Immediate Care & Family Practice, PA
• Med First Urgent Care, PLLC
• Med One
• Med One Medical Group
• Med-Caire Inc.
• Med-X Consulting, PC
• Medassist, Inc.
• Russell Glen Medders, MD
• Miriam Medero-Eng, MD

• Non-Pharmacy Dispensing Site in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Non-Pharmacy Dispensing Site in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.