Heritage Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6922 Issued in AK

Legal business name

HERITAGE MEDICAL GROUP LLC

Practice address

501 N Knik St
Wasilla, AK 99654-7050

Phone

(907) 232-8545

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John Zipperer Jr., MD

Title

Manager

Phone

(907) 232-8545

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1962705202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N KNIK ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547050",
            "telephone_number": "907-232-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N KNIK ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547050",
            "telephone_number": "907-232-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "ZIPPERER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-232-8545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "6922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Rene Henry
• Donald Kenton Henry, BSW SOCIAL WORKER
• William Henslee
• Alicia Henson
• Heritage Family Medicine LLC
• Kristal M Hermon
• Adriana Maria Hernandez, CNM, PMHNP-BC
• Mikaela Maree Hernandez, NP
• Jessica Herndon, MSW
• Garrick Dick Herr, PT, DPT

• Internal Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Internal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.