Organization Active NPI

Mertz MFM Center

  • Maternal & Fetal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1912577628
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
MERTZ MFM CENTER
Practice address
3815 Forrestgate Dr
Winston Salem, NC 27103-2930
Phone
(336) 480-4173
Fax
(276) 783-2879
NPI assigned
Jun 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Dr. Heather L. Mertz, MDNPI 1477533115
Title
Owner
Phone
(336) 480-4173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

3815 Forrestgate Dr
Winston Salem, NC 27103-2930

Mailing address

3815 Forrestgate Dr
Winston Salem, NC 27103-2930
Phone (336) 480-4173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211230000139 NC Part B Supplier - Clinic/Group Practice 9234520206 Receives reassigned benefits from 3 practitioners
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

3817 Forrestgate Dr
Ste B
Winston Salem, NC 27103

3815 Forrestgate Dr
Winston Salem, NC 27103
Phone (336) 480-4173

3817 Forrestgate Dr
Winston Salem, NC 27103
Phone (336) 765-9314

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1912577628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 FORRESTGATE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032930",
            "telephone_number": "336-480-4173",
            "fax_number": "276-783-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FORRESTGATE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032930",
            "telephone_number": "336-480-4173",
            "fax_number": "276-783-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERTZ MFM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-26",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "MERTZ",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-480-4173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.