NPIMap

Organization Active NPI

Rowan Diagnostic Clinic, PA

Doing business as Faith Internal Medicine

  • Internal Medicine Physician
  • Faith, NC
National Provider Identifier
1023471869
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROWAN DIAGNOSTIC CLINIC, PA
Doing business as
Faith Internal Medicine
Practice address
1000 Brown Street
Faith, NC 28041
Phone
(704) 633-7220
Fax
(704) 647-0515
NPI assigned
Mar 30, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ROWAN DIAGNOSTIC CLINIC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul A Verhaeghe
Title
Ceo
Phone
(704) 633-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1000 Brown Street
Faith, NC 28041

Mailing address

611 Mocksville Ave
Salisbury, NC 28144-2705
Phone (704) 633-7220

Other names 1

  • Faith Internal Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000907 NC Part B Supplier - Clinic/Group Practice 9335037944 Receives reassigned benefits from 32 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salisbury, NC; Faith, NC

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Rowan Diagnostic Clinic10 organizations share this tax ID, including this one
Part of
Rowan Diagnostic Clinic

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023471869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BROWN STREET",
            "city": "FAITH",
            "state": "NC",
            "postal_code": "28041",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROWAN DIAGNOSTIC CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROWAN DIAGNOSTIC CLINIC, PA",
        "enumeration_date": "2016-03-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VERHAEGHE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-633-7220"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faith Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Faith, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.