OrganizationActive
Raleigh Durham Medical Group PA
NPI 1164865416 · Non-Pharmacy Dispensing Site · Clayton, NC
Raleigh Durham Medical Group PA is a Non-Pharmacy Dispensing Site organization in Clayton, NC (NPI 1164865416).
Provider details
- NPI number
- 1164865416
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 964-1506
- License
- 200400430 (NC)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2076 Highway 42 West
Suite 230
Clayton, NC 27520
Phone: (919) 553-5711
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Family Wellness Clinic
Registry dates
- Enumerated
- 2013-04-16
- Last updated
- 2013-04-16
Frequently asked questions
- What is Raleigh Durham Medical Group PA's NPI number?
- Raleigh Durham Medical Group PA's National Provider Identifier (NPI) is 1164865416, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Raleigh Durham Medical Group PA?
- Raleigh Durham Medical Group PA is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Raleigh Durham Medical Group PA located?
- Raleigh Durham Medical Group PA's practice location on file with NPPES is 2076 Highway 42 West, Clayton, NC 27520.
- What is Raleigh Durham Medical Group PA's phone number?
- The practice phone number listed in the NPPES registry for Raleigh Durham Medical Group PA is (919) 553-5711.
- Who is the authorized official for Raleigh Durham Medical Group PA?
- The authorized official listed on Raleigh Durham Medical Group PA's NPPES record is Kenny Heine, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Raleigh Durham Medical Group PA's NPI active?
- Yes — Raleigh Durham Medical Group PA's NPI (1164865416) is active in the NPPES registry as of the last update on 2013-04-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.