NPIMap

Organization Active NPI

Moses Cone Physician Services, Inc

Doing business as The Clinic at Walmart Burlington

  • Family Medicine Physician
  • Burlington, NC
National Provider Identifier
1194007583
Registry record updated Oct 19, 2011
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
The Clinic at Walmart Burlington
Practice address
3141 Garden Rd
Burlington, NC 27215-9786
Phone
(336) 584-0108
Fax
(336) 584-8835
NPI assigned
Sep 13, 2011
Last updated
Oct 19, 2011By 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 Oct 19, 2011

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

Authorized official

Name
Mr. Kenneth K Boggs
Title
Cfo / Treasurer
Phone
(336) 832-8005

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

3141 Garden Rd
Burlington, NC 27215-9786

Mailing address

1200 N Elm St
Cone Health, Asb, Suite 201
Greensboro, NC 27401-1004
Phone (336) 832-8005

Other names 1

  • The Clinic at Walmart Burlington 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 Cone Mem Hosp

Practitioners & affiliated clinicians

Practitioners 5

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": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1194007583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "address_2": "CONE HEALTH, ASB, SUITE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-8005",
            "fax_number": "336-832-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 GARDEN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159786",
            "telephone_number": "336-584-0108",
            "fax_number": "336-584-8835"
        }
    ],
    "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": "2011-09-13",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO / TREASURER",
        "authorized_official_telephone_number": "336-832-8005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic at Walmart Burlington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.