NPIMap

Organization Active NPI

Eagle Physicians and Associates PA

  • Pediatrics Physician
  • Greensboro, NC
National Provider Identifier
1013086321
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EAGLE PHYSICIANS AND ASSOCIATES PA
Practice address
5500 W Friendly Ave Ste 200
Greensboro, NC 27410-4368
Phone
(336) 373-1996
Fax
(336) 482-2320
NPI assigned
Nov 8, 2006
Organization subpart
Yes
Parent organization
EAGLE PHYSICIANS AND ASSOCIATES PAAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Terri S. Jones
Title
Director, Eagle Business Services
Phone
(336) 268-3201

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0993821Eagle Pediatrics5500 West Friendly Avenue, Greensboro, NC 27410Certificate of waiverDec 21, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000436 NC Part B Supplier - Clinic/Group Practice 0244134468 Receives reassigned benefits from 207 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oak Ridge, NC; Greensboro, NC

National Provider Directory

National Provider Directory
Part of
Eagle Sleep Center

Locations

5500 W Friendly Ave
Ste 200
Greensboro, NC 27410
Phone (336) 292-4516

301 E Wendover Ave
Ste 215
Greensboro, NC 27401
Phone (336) 268-3129

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAEGAA

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

NPPES NPI Registry

Primary practice location

5500 W Friendly Ave Ste 200
Greensboro, NC 27410-4368

Mailing address

PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 482-2300

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
89012XVMedicaidNC
012XVOtherNCBCBS OF NC

Other names 1

NPPES NPI Registry
  • Eagle Pediatrics Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2020.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1013086321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-482-2300",
            "fax_number": "336-482-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 W FRIENDLY AVE STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104368",
            "telephone_number": "336-373-1996",
            "fax_number": "336-482-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE PHYSICIANS AND ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE PHYSICIANS AND ASSOCIATES PA",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR, EAGLE BUSINESS SERVICES",
        "authorized_official_telephone_number": "336-268-3201"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012XV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "012XV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.