NPIMap

Organization Active NPI

Belmont Medical Associates PLLC

  • Family Medicine Physician
  • Reidsville, NC
National Provider Identifier
1255334181
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BELMONT MEDICAL ASSOCIATES PLLC
Practice address
1818 Richardson Dr
Ste a
Reidsville, NC 27320-5450
Phone
(336) 349-5040
Fax
(336) 369-5368
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
Sandra C Thompson
Title
CPC, DO
Phone
(336) 349-5040

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1818 Richardson Dr
Ste a
Reidsville, NC 27320-5450

Mailing address

1818 Richardson Dr
Ste a
Reidsville, NC 27320-5450
Phone (336) 349-5040

Other identifiers 1

IdentifierTypeStateIssuer
8902523MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070207000205 NC Part B Supplier - Clinic/Group Practice 0143222901 Receives reassigned benefits from 2 practitioners
Practice locations: Reidsville, NC

National Provider Directory

National Provider Directory

Locations

1818 Richardson Dr
Ste A
Reidsville, NC 27320
Phone (336) 349-3171

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1255334181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 RICHARDSON DR",
            "address_2": "STE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205450",
            "telephone_number": "336-349-5040",
            "fax_number": "336-369-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 RICHARDSON DR",
            "address_2": "STE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205450",
            "telephone_number": "336-349-5040",
            "fax_number": "336-369-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CPC, DO",
        "authorized_official_telephone_number": "336-349-5040"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902523",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 22, 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.