NPIMap

Organization Active NPI

Forsyth Memorial Hospital, Inc

Doing business as CRNA Kernersville

  • Certified Registered Nurse Anesthetist
  • Kernersville, NC
National Provider Identifier
1174826077
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
FORSYTH MEMORIAL HOSPITAL, INC
Doing business as
CRNA Kernersville
Practice address
654 Wishbone Farm Rd
Kernersville, NC 27284-7947
Phone
(888) 844-0080
NPI assigned
Dec 15, 2010
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Fred M. Hargett
Title
Evp/Cfo
Phone
(704) 316-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NC Primary

Addresses

Primary practice location

654 Wishbone Farm Rd
Kernersville, NC 27284-7947

Mailing address

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (336) 277-7226

Other names 1

  • CRNA Kernersville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Novant Health58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1174826077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 WISHBONE FARM RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847947",
            "telephone_number": "888-844-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "HARGETT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRNA Kernersville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CRNA Kernersville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.