Active NPI
Forsyth Memorial Hospital, Inc
Doing business as Piedmont Medical Specialist
- Infectious Disease Physician
- Winston Salem, NC
National Provider Identifier
1043278971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- FORSYTH MEMORIAL HOSPITAL, INC
- Doing business as
- Piedmont Medical Specialist
- Practice address
- 1381 Westgate Center Dr
Piedmont Medical Specialist
Winston Salem, NC 27103-2934 - Phone
- (336) 718-0480
- Fax
- (336) 718-0484
- NPI assigned
- May 2, 2006
- Last updated
- Aug 14, 2008
- Organization subpart
- Yes
- Parent organization
- FORSYTH MEMORIAL HOSPITAL, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michele Grier
- Title
- VP Operations
- Phone
- (336) 718-0480
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Nurse Practitioner | 363L00000X | NU | ||
| Infectious Disease Physician | 207RI0200X | NU | Primary |
Addresses
Primary practice location
1381 Westgate Center Dr
Piedmont Medical Specialist
Winston Salem, NC 27103-2934
Mailing address
2000 Frontis Plaza Blvd Ste 200
(Attn) Forsyth Medical Group
Winston Salem, NC 27103-5616
Phone (336) 718-0480
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890167Y | Medicaid | NC | |
| CA1315 | Other | NC | RAILROAD MEDICARE |
Other names 1
- Piedmont Medical Specialist
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040405001702 | NC | Part B Supplier - Clinic/Group Practice | 9537071790 |
Receives reassigned benefits from 1,329 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Novant Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218672000000",
"number": "1043278971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 FRONTIS PLAZA BLVD STE 200",
"address_2": "(ATTN) FORSYTH MEDICAL GROUP",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035616",
"telephone_number": "336-718-0480",
"fax_number": "336-718-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1381 WESTGATE CENTER DR",
"address_2": "PIEDMONT MEDICAL SPECIALIST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271032934",
"telephone_number": "336-718-0480",
"fax_number": "336-718-0484"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FORSYTH MEMORIAL HOSPITAL, INC",
"enumeration_date": "2006-05-02",
"last_updated": "2008-08-14",
"status": "A",
"authorized_official_last_name": "GRIER",
"authorized_official_first_name": "MICHELE",
"authorized_official_title_or_position": "VP OPERATIONS",
"authorized_official_telephone_number": "336-718-0480"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890167Y",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CA1315",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Piedmont Medical Specialist",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Winston Salem, NC
- Forsyth Memorial Hospital Inc (Novant Health Premier Medical Associates)
- Forsyth Memorial Hospital Inc (Novant Health Salem Family Medicine)
- Forsyth Memorial Hospital Inc (Novant Health Maplewood Family Medicine)
- Forsyth Memorial Hospital Inc (Novant Health Inpatient Stroke and Neurosciences)
- Forsyth Memorial Hospital, Inc (Novant Health Cancer Institute)
- Forsyth Memorial Hospital, Inc (Forsyth Critical Care)
- Forsyth Memorial Hospital, Inc (Novant Health Metcalf Rheumatology)
- Forsyth Memorial Hospital, Inc (Piedmont Medical Specialist (PCP))
- Forsyth Memorial Hospital, Inc (Novant Health Urology)
- Forsyth Memorial Hospital, Inc (Novant Health Winston Salem Cardiology)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.