NPIMap

Organization Active NPI

Moses Cone Physician Services, Inc.

Doing business as Cone Health Medical Group LeBauer Summerfield Village

  • Family Medicine Physician
  • Summerfield, NC
National Provider Identifier
1124574827
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOSES CONE PHYSICIAN SERVICES, INC.
Doing business as
Cone Health Medical Group LeBauer Summerfield Village
Practice address
4446 US Highway 220 North
Suite a
Summerfield, NC 27358
Phone
(336) 832-3384
NPI assigned
Sep 1, 2016
Last updated
Sep 1, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Robert L Goldstein
Title
Executive Vice President
Phone
(336) 663-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4446 US Highway 220 North
Suite a
Summerfield, NC 27358

Mailing address

1200 North Elm Street
Greensboro, NC 27401-1020

Other names 1

  • Cone Health Medical Group LeBauer Summerfield Village Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory
Part of
Moses H Cone Memorial H

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1124574827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORTH ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4446 US HIGHWAY 220 NORTH",
            "address_2": "SUITE A",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "27358",
            "telephone_number": "336-832-3384"
        }
    ],
    "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": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "336-663-5011"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cone Health Medical Group LeBauer Summerfield Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.