NPIMap

Organization Active NPI

Forsyth Memorial Hospital, Inc.

Doing business as NH Bermuda Run Family Medicine

  • Family Medicine Physician
  • Advance, NC
National Provider Identifier
1053812875
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORSYTH MEMORIAL HOSPITAL, INC.
Doing business as
NH Bermuda Run Family Medicine
Practice address
5380 US Highway 158 Ste 110
Advance, NC 27006-6974
Phone
(336) 893-3210
NPI assigned
Feb 27, 2018
Last updated
Feb 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Shala Davis
Title
Manger RCS
Phone
(704) 316-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

5380 US Highway 158 Ste 110
Advance, NC 27006-6974

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other names 1

  • NH Bermuda Run Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Novant Health58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1053812875",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 US HIGHWAY 158 STE 110",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270066974",
            "telephone_number": "336-893-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "MANGER RCS",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NH Bermuda Run Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Advance, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.