Heritage Medical Care
NPI 1184549693ActiveOrganization· Nurse Practitioner, Primary Care· Sparta, TN
Nurse Practitioner, Primary Care in Sparta, Tennessee, registered in NPPES in August 2026. The authorized official on file is Kimberly Dawn Wagner, FNP-BC, Owner.
Overview
| NPI | 1184549693 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 12, 2026 |
| Last updated in NPPES | Aug 12, 2026 |
| Certified by provider | Aug 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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