Heritage Care of Elizabeth City, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-070-006 Issued in NC

Legal business name

HERITAGE CARE OF ELIZABETH CITY, LLC

Practice address

100 Timmerman Dr
Elizabeth City, NC 27909-9621

Phone

(252) 338-2816

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Guy S Pierce

Title

Managing Member

Phone

(336) 595-1075

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952486326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1487",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272851487",
            "telephone_number": "336-595-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TIMMERMAN DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099621",
            "telephone_number": "252-338-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CARE OF ELIZABETH CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "336-595-1075"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-070-006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804336",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas J Henderson, M.S., CCC-A
• Michelle Henning, DO
• Kristal Jade Henry, DC
• Madahari Tyler Aldhem Henry, MD
• Melissa Dawn Henry, LPC, LCMHC
• Albrecht Mark Heyder, MD
• Chiarina Simeone Heyder, PA-C
• Michael Hibbert
• Bailey Ann Hicks
• Rebecca Meads Higgins, LPTA

• Assisted Living Facility in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.