NPIMap

Organization Active NPI

Moses Cone Affiliated Physicians, Inc

  • Obstetrics & Gynecology Physician
  • Reidsville, NC
National Provider Identifier
1356506992
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MOSES CONE AFFILIATED PHYSICIANS, INC
Practice address
520 Maple Ave
Suite C
Reidsville, NC 27320-4652
Phone
(336) 342-6063
Fax
(336) 342-7847
NPI assigned
Jul 23, 2008
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Authorized official

Name
Robert L Goldstein
Title
Executive Vice President
Phone
(336) 832-6250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

520 Maple Ave
Suite C
Reidsville, NC 27320-4652

Mailing address

PO Box 405633
Atlanta, GA 30384-5633
Phone (336) 342-6063

Other identifiers 1

IdentifierTypeStateIssuer
1356506992MedicaidNC

Other names 1

  • Family Tree OB/GYN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000512 NC Part B Supplier - Clinic/Group Practice 3779635396 Receives reassigned benefits from 86 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Reidsville, NC; Oak Ridge, NC; Kernersville, NC; High Point, NC; Burlington, NC; Asheboro, NC

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory
Part of
Moses Cone Mem Hosp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1356506992",
    "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": "336-342-6063",
            "fax_number": "336-342-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAPLE AVE",
            "address_2": "SUITE C",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273204652",
            "telephone_number": "336-342-6063",
            "fax_number": "336-342-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE AFFILIATED PHYSICIANS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-23",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "336-832-6250"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356506992",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Tree OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 12, 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.