Heritage Homecare of Gastonia

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HERITAGE HOMECARE OF GASTONIA

Practice address

1913 J N Pease PL Ste 103
Charlotte, NC 28262-4537

Phone

(704) 763-7168

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Rico Akiva Wagner

Title

Owner

Phone

(704) 763-2168

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1932607108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 J N PEASE PL STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624537",
            "telephone_number": "704-763-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 J N PEASE PL STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624537",
            "telephone_number": "704-763-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HOMECARE OF GASTONIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICO",
        "authorized_official_middle_name": "AKIVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-763-2168",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herealgood, LLC (The Charlotte PT Room)
• Nicole Hereim
• Teal M Herendeen, OMT
• Heritage Home Care of Charlotte
• Heritage Home Care of Greensboro Inc. (Heritage Home Care Agency Inc.)
• Heritage House Human Services Inc
• Heritage Regenerative Medicine Inc.
• Timothy Gordon Herlihy, OT/L
• Amanda Herlocker, M.S., R.D.N., L.D.N.
• Kalie Anne Herman, MS, RD

• In Home Supportive Care Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.