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HERITAGE WELLNESS CLINIC LLC
NPI 1619483294
Internal Medicine in Saint Peters, MO

Active since December 19, 2017
2730 S SAINT PETERS PKWY, SAINT PETERS, MO 63303(636) 277-9927(636) 295-4741 Get Directions Write a Review

NPPES record last updated: December 19, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Heritage Wellness Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERITAGE WELLNESS CLINIC LLC (NPI 1619483294) is a healthcare organization registered as an internal medicine in Saint Peters, Missouri and active in the NPI registry since December 2017. The organization lists Kimberly Wyatt, Cred. Spec., as its authorized official.

NPPES Registry Identity

NPI1619483294
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameHERITAGE WELLNESS CLINIC LLC
Location Address2730 S SAINT PETERS PKWYSaint Peters, MO 63303-5677
Mailing Address2730 S Saint Peters PkwySaint Peters, MO 63303-5677 · (636) 277-9927 · Fax (636) 295-4741
Phone(636) 277-9927
Fax(636) 295-4741
Organization SubpartNo
Authorized OfficialKimberly WyattCred. Spec. · (636) 277-9927
Enumeration DateDecember 19, 2017
✔ NPI 1619483294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2730 S SAINT PETERS PKWY, Saint Peters, MO 63303
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heritage Wellness Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Heritage Wellness Clinic LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Abid Nisar, MD
Internal Medicine
NPI 1245375567
2730 S SAINT PETERS PKWY STE 103
Saint Peters, MO 63303
(314) 960-1052
✔ PECOS✔ Accepts Medicare3.8 mi
Khaled Hassan, MD
Internal Medicine
NPI 1841303310
12800 BOENKER LN
Bridgeton, MO 63044
(314) 551-0338
✔ PECOS6.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heritage Wellness Clinic LLC's NPI number?

The NPI number for Heritage Wellness Clinic LLC is 1619483294. It was assigned to this organization in the NPPES registry on December 19, 2017.

Where is Heritage Wellness Clinic LLC located?

Heritage Wellness Clinic LLC is located at 2730 S Saint Peters Pkwy, Saint Peters, MO 63303. The listed phone number is (636) 277-9927.

What is Heritage Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Heritage Wellness Clinic LLC enrolled in Medicare?

Yes. Heritage Wellness Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Heritage Wellness Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Heritage Wellness Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Heritage Wellness Clinic LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list Heritage Wellness Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Heritage Wellness Clinic LLC was last updated on December 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.