NPIMap

Organization Active NPI

The Moses H Cone Memorial Hospital Operating Corporation

Doing business as Cone , Annie Penn, Randolph Cancer Centers

  • Multi-Specialty Clinic/Center
  • Greensboro, NC
National Provider Identifier
1265589097
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Doing business as
Cone , Annie Penn, Randolph Cancer Centers
Practice address
501 N Elam Ave
Greensboro, NC 27403-1118
Phone
(336) 832-1100
NPI assigned
Jan 4, 2007
Last updated
Sep 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
David L Kitzmiller
Title
Assistant Treasurer
Phone
(336) 832-7579

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Physician Assistant 363A00000X NC
Nurse Practitioner 363L00000X NC
Internal Medicine Physician 207R00000X NC
Hematology (Internal Medicine) Physician 207RH0000X NC
Hematology & Oncology Physician 207RH0003X NC
Infectious Disease Physician 207RI0200X NC
Medical Oncology Physician 207RX0202X NC

Addresses

Primary practice location

501 N Elam Ave
Greensboro, NC 27403-1118

Mailing address

PO Box 405633
Atlanta, GA 30384-5633
Phone (336) 832-7579

Other identifiers 1

IdentifierTypeStateIssuer
1265589097MedicaidNC

Other names 1

  • Cone , Annie Penn, Randolph Cancer Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000940 NC Part B Supplier - Clinic/Group Practice 6204744600 Receives reassigned benefits from 80 practitioners
1 other NPI on this enrollment
Practice locations: Greensboro, NC; Reidsville, NC; High Point, NC; Burlington, NC; Asheboro, NC

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

802 Green Valley Rd
Greensboro, NC 27408
Phone (234) 567-8901

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alamance Regional Medical Center IncBurlington, NC, CCN 34S070 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 79

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 79

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1265589097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405633",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845633",
            "telephone_number": "336-832-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031118",
            "telephone_number": "336-832-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "KITZMILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT TREASURER",
        "authorized_official_telephone_number": "336-832-7579"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265589097",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cone , Annie Penn, Randolph Cancer Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.