Organization
MED ONE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY L. CONNER (INSURANCE AND BILLING MANAGER)
(919) 850-1300
Entity
Organization
Contact information
Practice address
7019-200 HARPS MILL RD., RALEIGH, NC 27615
(919) 850-1300
(919) 850-0012
Mailing address
7019-200 HARPS MILL RD., RALEIGH, NC 27615
(919) 850-1300
(919) 850-0012
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2394
NC
207R00000X
Internal Medicine Physician
930076
NC
207R00000X
Internal Medicine Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
0050-02018
NC
363LF0000X
Family Nurse Practitioner
201835
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-04356
LICENSE # - TYLER CASSIDY
NC
01
—
0050-02018
J. CHARLES ANP LISCENSE
NC
01
—
2394
G. GRUBER DC LICENSE #
NC
01
—
5011967
LICENSE # - KERNEY YU
NC
01
—
930076
CARA L. DAVIS LICENSE
NC
Enumeration date
10/27/2006
Last updated
03/07/2023
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