NPIMap

Organization Active NPI

Davie County Emergency Health Corp

Doing business as Davie County Hospital & Wake Forest Baptist health-Davie

  • Emergency Medicine Physician
  • Mocksville, NC
National Provider Identifier
1235268384
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
943133 Issued in NC
Legal business name
DAVIE COUNTY EMERGENCY HEALTH CORP
Doing business as
Davie County Hospital & Wake Forest Baptist health-Davie
Practice address
223 Hospital St
Mocksville, NC 27028-2038
Phone
(336) 702-5500
Fax
(336) 702-5701
NPI assigned
Mar 5, 2007
Last updated
Jun 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Kevin G. Walsh
Title
Administrator
Phone
(336) 702-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 943133 NC Primary

Addresses

Primary practice location

223 Hospital St
Mocksville, NC 27028-2038

Mailing address

223 Hospital St
Mocksville, NC 27028-2038
Phone (336) 702-5500

Other identifiers 1

IdentifierTypeStateIssuer
89015WYMedicaidNC

Other names 1

  • Davie County Hospital & Wake Forest Baptist health-Davie Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davie County Emergency Health Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1235268384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 HOSPITAL ST",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282038",
            "telephone_number": "336-702-5500",
            "fax_number": "336-702-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 HOSPITAL ST",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282038",
            "telephone_number": "336-702-5500",
            "fax_number": "336-702-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIE COUNTY EMERGENCY HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-702-5501"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "943133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015WY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davie County Hospital & Wake Forest Baptist health-Davie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mocksville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.