NPIMap

Organization Active NPI

Moses Cone Physician Services, Inc.

Doing business as Gosrani Optimal Health

  • Internal Medicine Physician
  • Reidsville, NC
National Provider Identifier
1194233171
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MOSES CONE PHYSICIAN SERVICES, INC.
Doing business as
Gosrani Optimal Health
Practice address
118 S Scales St
Reidsville, NC 27320-3834
Phone
(336) 347-0511
Fax
(336) 347-0410
NPI assigned
Jan 12, 2018
Last updated
Jan 12, 2018By 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 Jan 12, 2018

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

Authorized official

Name
Sally Patricia Hammond
Title
Executive Director
Phone
(336) 663-5007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

118 S Scales St
Reidsville, NC 27320-3834

Mailing address

300 E Wendover Ave FL 4
Greensboro, NC 27401-1229

Other names 1

  • Gosrani Optimal Health 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

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1194233171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E WENDOVER AVE FL 4",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S SCALES ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203834",
            "telephone_number": "336-347-0511",
            "fax_number": "336-347-0410"
        }
    ],
    "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": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-663-5007"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gosrani Optimal Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; 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.