HERITAGE FAMILY MEDICINE – NPI #1114141744
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

HERITAGE FAMILY MEDICINE is a provider located in MADISON, AL. NPPES has assigned the NPI number 1114141744 to HERITAGE FAMILY MEDICINE on April 13, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HERITAGE FAMILY MEDICINE” is a dba name, the actual legal business name for this organization is DAWN B MANCUSO, MD, LLC. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 8 years ago on Dec 07, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HERITAGE FAMILY MEDICINE below.

NPI Profile for
DAWN B MANCUSO, MD, LLC

NPI Number
1114141744
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DAWN B MANCUSO, MD, LLC
Doing Business As (dba): HERITAGE FAMILY MEDICINE
Primary location
12205 COUNTY LINE RD
SUITE B
MADISON, AL 35758-7719
Phone: (256) 990-8446 Fax: (256) 461-0393
Mailing address
PO BOX 617
MADISON, AL 35758-0617
Phone: (256) 990-8446 Fax: (256) 461-0393
Organization Subpart
No
Authorized Official
ANTHONY MANCUSO
CFO
Phone: (256) 990-8446
Updated
Identifiers

Identifiers for HERITAGE FAMILY MEDICINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMANCUSO BCBSAL051506404
MEDICAIDAL529910550
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
AL 00015990

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.