NPIMap

Moses Cone Physician Services, Inc.

Organization Active NPI Rheumatology Physician · Greensboro, NC

NPI 1104458454 · NPPES record last updated Feb 5, 2020

Key facts

NPI
1104458454
Entity type
Organization (NPI type 2)
Primary specialty
Rheumatology Physician 207RR0500X
Legal business name
MOSES CONE PHYSICIAN SERVICES, INC.
Practice address
1313 Carolina St Ste 101
Greensboro, NC 27401-6002
Phone
(336) 275-0927
Fax
(336) 275-4834
NPI assigned
Feb 5, 2020
Organization subpart
Yes
Parent organization (as reported)
THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Authorized official

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

Other NPIs on the same Medicare enrollment 25

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

Corporate family (same tax ID) 14

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090501000202 NC Part B Supplier - Clinic/Group Practice 4284782210 Receives reassigned benefits from 758 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mebane, NC; Greensboro, NC; High Point, NC; Kernersville, NC; Madison, NC; Reidsville, NC; Burlington, NC; Eden, NC

National Provider Directory

Tax ID family
Moses Cone Physician Services Inc (15 organizations share this tax ID)
Part of
Moses Cone Mem Hosp

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RR0500X Yes

Addresses

Primary practice location

1313 Carolina St Ste 101
Greensboro, NC 27401-6002

Mailing address

PO Box 745040
Atlanta, GA 30374-5040

Other names

  • CHMG Rheumatology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 5, 2020.

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1104458454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745040",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 CAROLINA ST STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016002",
            "telephone_number": "336-275-0927",
            "fax_number": "336-275-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, OPERATIONS",
        "authorized_official_telephone_number": "336-663-5007"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHMG Rheumatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

All providers in Greensboro, NC · Rheumatology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.