Individual provider Active NPI

Paul Leslie Garrison Jr., MD

  • Internal Medicine Physician
  • Elkin, NC
National Provider Identifier
1275585960
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33044 Issued in NC
Practice address
500 Chatham Medical Park
Elkin, NC 28621-2481
Phone
(336) 835-3136
Fax
(336) 835-6038
NPI assigned
May 17, 2006
Last updated
Aug 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33044 NC Primary

Addresses

Primary practice location

500 Chatham Medical Park
Elkin, NC 28621-2481

Mailing address

500 Chatham Medical Park
Elkin, NC 28621-2481
Phone (336) 835-3136

Other identifiers 1

IdentifierTypeStateIssuer
8934722MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000726 NC Practitioner - Internal Medicine 1456476324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wake Forest University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Chatham Medical Park
Elkin, NC 28621-2481
Phone (336) 835-3136

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33044NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Chatham Memorial Hospital, Inc. Internal Medicine Current Accepting new patients
Hugh Chatham Memorial Hospital CurrentSince Nov 1, 1996 Accepting new patients
Hugh Chatham Memorial Hospital, Inc Past Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Past Accepting new patients

Locations

360 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-5960

500 Chatham Medical Park
Elkin, NC 28621
Phone (336) 835-3136

Interoperability endpoints

  • Direct secure messaging: pgarrison@hcn.gwaydirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1275585960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHATHAM MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212481",
            "telephone_number": "336-835-3136",
            "fax_number": "336-835-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHATHAM MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212481",
            "telephone_number": "336-835-3136",
            "fax_number": "336-835-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "PAUL",
        "middle_name": "LESLIE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "33044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8934722",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.