Forsyth Memorial Hospital Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL INC

Doing business as

Novant Health Surry Medical Associates

Practice address

2133 Rockford St
Suite 1400
Mount Airy, NC 27030-6587

Phone

(336) 719-0398

Fax

(336) 719-0494

NPI assigned

Jun 1, 2015

Last updated

Jun 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Geoffery Gardner

Title

VP of Finance

Phone

(336) 719-0398

Specialties & licenses 2

Addresses

Other names 1

• Novant Health Surry Medical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Heather Smith Hammaker, FNP

  • Nurse Practitioner
  • Mount Airy, NC
  • NPI 1952877938
  NPD
• Takashi Hirata, MD

  • Family Medicine Physician
  • Advance, NC
  • NPI 1629110036
  NPD
• Michele Mariano Lizano, FNP-C

  • Nurse Practitioner
  • King, NC
  • NPI 1033518311
  NPD
• Virginia L Orosz, PA-C

  • Physician Assistant
  • Rural Hall, NC
  • NPI 1730152109
  NPD
• Jay Richard Seidler, DO

  • Family Medicine Physician
  • Mount Airy, NC
  • NPI 1962407254
  NPD

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1043690522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-719-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 ROCKFORD ST",
            "address_2": "SUITE 1400",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270306587",
            "telephone_number": "336-719-0398",
            "fax_number": "336-719-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFERY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "336-719-0398"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Surry Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walter Joy Falardeau III, DPM
• Jason Lindsey Ferris, PA-C
• Katherine Fleming, OTR/L
• Virginia Taylor Floyd, MD
• Elizabeth Nail Ford, DPT
• Forsyth Memorial Hospital Inc (Novant Health Cancer Institute)
• Forsyth Memorial Hospital, Inc (Novant Health Surry Medical Associates)
• Forsyth Memorial Hospital, Inc (Novant Health Cardiology Mount Airy)
• Forsyth Memorial Hospital, Inc (Medical Associates of Surry)
• Cindy Fortner, CRNA

• Family Medicine Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.