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Contact Information

MED ONE MEDICAL GROUP
7019-200 HARPS MILL RD.
RALEIGH, NC27615
 Phone: 919-850-1300
 Fax: 919-850-0012
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Adult Health

363LA2200X 50 Nurse Practitioner
 

Chiropractor

111N00000X 35 Chiropractic
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MED ONE MEDICAL GROUP

NPI Number 1548346331
LBN Legal business name MED ONE MEDICAL GROUP
Authorized official TIFFANY CONNER - (INSURANCE AND BILLING MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/27/2006
Last updated 03/07/2023 - About 3 years ago
Identifiers
NC License # 0050-02018
NC License # 201835
NC License # 2394
NC License # 930076
NC Other 930076 CARA L. DAVIS LICENSE
NC Other 2394 G. GRUBER DC LICENSE #
NC Other 0050-02018 J. CHARLES ANP LISCENSE
NC Other 5011967 LICENSE # - KERNEY YU
NC Other 0010-04356 LICENSE # - TYLER CASSIDY
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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