NPIMap

Organization Active NPI

North Carolina Baptist Hospital

Doing business as Piedmont Plaza Pharmacy

  • Community/Retail Pharmacy
  • Winston Salem, NC
National Provider Identifier
1073732376
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
05465 Issued in NC
Legal business name
NORTH CAROLINA BAPTIST HOSPITAL
Doing business as
Piedmont Plaza Pharmacy
Practice address
1920 W 1St St
Main Floor Piedmont Plaza One
Winston Salem, NC 27104-4220
Phone
(336) 716-5800
Fax
(336) 716-0528
NPI assigned
Apr 25, 2007
Last updated
Oct 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Authorized official

Name
Regina H Schomberg, PHARMD, BCPS
Title
Director of Pharmacy
Phone
(336) 713-3421

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 05465 NC Primary

Addresses

Primary practice location

1920 W 1St St
Main Floor Piedmont Plaza One
Winston Salem, NC 27104-4220

Mailing address

1920 W 1St St
Winston Salem, NC 27104-4220
Phone (336) 716-5800

Other identifiers 1

IdentifierTypeStateIssuer
0346411MedicaidNC

Other names 1

  • PIEDMONT PLAZA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200813002886 NC Part B Supplier - Pharmacy 6002725272 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winston Salem, NC; Clemmons, NC; Bermuda Run, NC
O20200917001023 NC Part B Supplier - Mass Immunization (Roster Biller Only) 6002725272 Practice locations: Winston Salem, NC

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Baptist H29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1920 W 1st St
Winston Salem, NC 27104
Phone (336) 716-4479

1920 W 1st St
#One
Winston Salem, NC 27104
Phone (336) 716-5800

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wilkes Regional Medical CenterNorth Wilkesboro, NC, CCN 340064 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
North Carolina Baptist HospitalWinston Salem, NC, CCN 340047 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
High Point Medical CenterHigh Point, NC, CCN 340004 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
Lexington Medical CenterLexington, NC, CCN 340096 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
High Point Medical CenterHigh Point, NC, CCN 34T004 Hospital 5% Or Greater Indirect Ownership Interest (40%) Oct 9, 2020
North Carolina Baptist HospitalWinston Salem, NC, CCN 34T047 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
North Carolina Baptist HospitalWinston Salem, NC, CCN 34S047 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
North Carolina Baptist HospitalWinston Salem, NC, CCN 342304 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 9, 2020
Wilkes Regional Medical Center SNFNorth Wilkesboro, NC, CCN 345386 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (40%) Jul 1, 2017

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1073732376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-5800",
            "fax_number": "336-716-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "address_2": "MAIN FLOOR PIEDMONT PLAZA ONE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-5800",
            "fax_number": "336-716-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA BAPTIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "SCHOMBERG",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "336-713-3421",
        "authorized_official_credential": "PHARMD, BCPS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "05465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346411",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIEDMONT PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIEDMONT PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.