NPIMap

Organization Active NPI

Bethany Medical Center, PA

  • Cardiovascular Disease Physician
  • High Point, NC
National Provider Identifier
1174722391
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BETHANY MEDICAL CENTER, PA
Practice address
3610 Peters CT
High Point, NC 27265-9004
Phone
(336) 883-0029
Fax
(336) 883-8988
NPI assigned
Jul 17, 2007
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Dr. Lenin J Peters, MDNPI 1083638860
Title
President/Ceo
Phone
(336) 883-0029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Gastroenterology Physician 207RG0100X NU
Pulmonary Disease Physician 207RP1001X NU

Addresses

Primary practice location

3610 Peters CT
High Point, NC 27265-9004

Mailing address

645 N Main St
High Point, NC 27260-5017
Phone (336) 883-0029

Other identifiers 1

IdentifierTypeStateIssuer
5907644MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000729 NC Part B Supplier - Clinic/Group Practice 4486614575 Receives reassigned benefits from 88 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Winston Salem, NC; North Wilkesboro, NC; Mount Airy, NC; Kernersville, NC; Jamestown, NC; Greensboro, NC

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Locations

1580 Skeet Club Rd
High Point, NC 27265
Phone 336883002912268

495 Arbor Hill Rd
Kernersville, NC 27284

495 Arbor Hill Rd
Ste M
Kernersville, NC 27284

975 NC Highway 66 S
Kernersville, NC 27284

Practitioners & affiliated clinicians

Practitioners 67

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.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1174722391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PETERS CT",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659004",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "LENIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "336-883-0029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907644",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.