Highroad Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36479 Issued in NC

Legal business name

HIGHROAD PEDIATRICS, PA

Practice address

815 Old Winston Rd
Kernersville, NC 27284-7121

Phone

(336) 996-3001

Fax

(336) 996-4687

NPI assigned

Jan 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Scott Eric Tolley

Title

Practice Administrator

Phone

(336) 765-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kernersville Pediatrics Doing business as

Tax ID family

Highroad Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Highroad Pediatrics

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1154348597
  NPD tax ID

Locations

Practitioners 1

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

• Nicole Wellman Rice

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1992904247
  NPD

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1144468083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034138",
            "telephone_number": "336-765-9000",
            "fax_number": "336-765-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 OLD WINSTON RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847121",
            "telephone_number": "336-996-3001",
            "fax_number": "336-996-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHROAD PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-765-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "36479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903823",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kernersville Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martha Claire K Henzler, PA-C
• Cassandra Hernandez
• Richard Edward Herrick, D.O.
• Heather Garner Herring, NP
• Kristin Marie Hess, PA-C
• Anitra Hilliard
• Janae Hilliard
• Kimberly Hilliard
• Madelyn Hilton
• Shonta S Hines

• Pediatrics Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.