NPIMap

Organization Active NPI

Telos Health Systems NC PLLC

  • Internal Medicine Physician
  • Mooresville, NC
National Provider Identifier
1265064414
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TELOS HEALTH SYSTEMS NC PLLC
Practice address
550 Glenwood Dr
Mooresville, NC 28115-2876
Phone
(201) 217-6777
Fax
(312) 276-8854
NPI assigned
Feb 6, 2020
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Peter Steven Bailey
Title
Ceo
Phone
(609) 480-0119

Specialties & licenses 1

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

Addresses

Primary practice location

550 Glenwood Dr
Mooresville, NC 28115-2876

Mailing address

980 Sylvan Ave FL 2
Englewood Cliffs, NJ 07632-3320
Phone (201) 217-6777

Other names 1

  • Vitae Health Medical North Carolina PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430000531 NC Part B Supplier - Clinic/Group Practice 7719317932 Receives reassigned benefits from 115 practitioners
Practice locations: Henderson, NC; Rutherfordton, NC; Monroe, NC; Mooresville, NC; Salisbury, NC; Swannanoa, NC; Wilkesboro, NC; Winston Salem, NC…

National Provider Directory

National Provider Directory

Locations

411 S Lasalle St
Durham, NC 27705
Phone (919) 383-5521

Practitioners & affiliated clinicians

Practitioners 119

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.

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1265064414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SYLVAN AVE FL 2",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323320",
            "telephone_number": "201-217-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 GLENWOOD DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152876",
            "telephone_number": "201-217-6777",
            "fax_number": "312-276-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELOS HEALTH SYSTEMS NC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-480-0119"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitae Health Medical North Carolina PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.