NPIMap

Organization Active NPI

Moses Cone Physician Services, Inc

  • Pediatrics Physician
  • Reidsville, NC
National Provider Identifier
1073881850
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MOSES CONE PHYSICIAN SERVICES, INC
Practice address
1816 Richardson Dr
Reidsville, NC 27320-5434
Phone
(336) 634-3902
Fax
(336) 634-3933
NPI assigned
Dec 7, 2011
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Authorized official

Name
Sally Patricia Hammond
Title
Executive Director, Operations
Phone
(336) 663-5007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1816 Richardson Dr
Reidsville, NC 27320-5434

Mailing address

1816 Richardson Dr
Reidsville, NC 27320-5434
Phone (336) 634-3902

Other names 1

  • Reidsville Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000512 NC Part B Supplier - Clinic/Group Practice 3779635396 Receives reassigned benefits from 86 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Reidsville, NC; Oak Ridge, NC; Kernersville, NC; High Point, NC; Burlington, NC; Asheboro, NC

Other NPIs on the same Medicare enrollment 35

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

View all 35

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0938479Reidsville Pediatrics1816 Richardson Drive, Reidsville, NC 27320Provider-performed microscopyJan 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Moses Cone Physician Services Inc15 organizations share this tax ID, including this one
Part of
Moses Cone Mem Hosp

Other organizations with this tax ID 14

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

View all 14

Locations

1200 N Elm St
Ste 201
Greensboro, NC 27401
Phone (336) 832-8005

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1073881850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 RICHARDSON DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205434",
            "telephone_number": "336-634-3902",
            "fax_number": "336-634-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 RICHARDSON DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205434",
            "telephone_number": "336-634-3902",
            "fax_number": "336-634-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2011-12-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, OPERATIONS",
        "authorized_official_telephone_number": "336-663-5007"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reidsville Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Reidsville Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.