Individual provider Active NPI

Carolita Belle Heritage, MD

  • Obstetrics & Gynecology Physician
  • Maplewood, MN
National Provider Identifier
1902290976
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25540 Issued in MS
Practice address
2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone
(651) 600-3035
Fax
(651) 348-8783
NPI assigned
Mar 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 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
Obstetrics & Gynecology Physician 207V00000X 25540 MS Primary

Addresses

Primary practice location

2603 White Bear Ave N
Maplewood, MN 55109-5110

Mailing address

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

Other practice location 1

1012 D A Biglane Dr
Brookhaven, MS 39601-2331
Phone (601) 833-8157

Other names 1

  • Carolita Belle Yoder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200622002237 MS Practitioner - Obstetrics/Gynecology 7517241201 Reassigns benefits to 1 organization
I20241008003339 MN Practitioner - Obstetrics/Gynecology 7517241201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25540MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Women'S Care, P.a. Obstetrics & Gynecology CurrentSince Sep 4, 2024 Accepting new patients
Oxford Clinic for Women, PLLC Current Accepting new patients
Southern Women'S Health, PLLC Obstetrics & Gynecology CurrentSince Jan 16, 2024 Accepting new patients
Southern Women'S Health, PLLC CurrentSince Jan 16, 2024 Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Comprehensive Healthcare for Women, PA Obstetrics & Gynecology PastSince Sep 4, 2024 Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients

Locations

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685

1012 D a Biglane Dr
Brookhaven, MS 39601
Phone (601) 833-8157

2610 S Lamar Blvd
Oxford, MS 38655
Phone (601) 932-5006

Interoperability endpoints

  • Direct secure messaging: carolita.heritage.1@28954.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA

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 1

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1902290976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095110",
            "telephone_number": "651-600-3035",
            "fax_number": "651-348-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095110",
            "telephone_number": "651-600-3035",
            "fax_number": "651-348-8783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 D A Biglane Dr",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "MS",
            "postal_code": "396012331",
            "country_code": "US",
            "telephone_number": "601-833-8157",
            "fax_number": "601-833-1633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERITAGE",
        "first_name": "CAROLITA",
        "middle_name": "BELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "25540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLITA",
            "last_name": "YODER",
            "middle_name": "BELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.