Cornerstone Health Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CORNERSTONE HEALTH CARE

Doing business as

Warren Stacks MD a Cornerstone Practice

Practice address

1400 Westgate Center Dr
Suite 140
Winston Salem, NC 27103-3112

Phone

(336) 802-2536

Fax

(336) 802-2534

NPI assigned

Dec 10, 2012

Organization subpart

No

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

Authorized official

Name

Grace E Terrell, M.D

Title

President/Ceo

Phone

(336) 802-2536

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Warren Stacks MD a Cornerstone Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1235474701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627008",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DR",
            "address_2": "SUITE 140",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033112",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "336-802-2536",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740203090",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warren Stacks MD a Cornerstone Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cornerstone Health Care, LLC (Asthma and Allergy Associates)
• Cornerstone Health Care, LLC (Cornerstone Health Care Urology at Winston Salem)
• Cornerstone Health Care, PA (Mothershed, Mothershed, Arne and Cates)

• Family Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.