NPIMap

Organization Active NPI

Moses Cone Affiliated Physicians, Inc.

Doing business as The Southeastern Heart and Vascular Center

  • Cardiovascular Disease Physician
  • Greensboro, NC
National Provider Identifier
1356614705
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MOSES CONE AFFILIATED PHYSICIANS, INC.
Doing business as
The Southeastern Heart and Vascular Center
Practice address
3200 Northline Ave
Suite 250
Greensboro, NC 27408-7619
Phone
(336) 273-7900
Fax
(336) 482-3517
NPI assigned
Feb 15, 2012
Last updated
Jun 3, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU

Addresses

Primary practice location

3200 Northline Ave
Suite 250
Greensboro, NC 27408-7619

Mailing address

PO Box 405633
Moses Cone Affiliated Physicians, Inc.
Atlanta, GA 30384-5633
Phone (336) 832-9943

Other names 1

  • The Southeastern Heart and Vascular Center 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

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1356614705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405633",
            "address_2": "MOSES CONE AFFILIATED PHYSICIANS, INC.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845633",
            "telephone_number": "336-832-9943",
            "fax_number": "336-832-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVE",
            "address_2": "SUITE 250",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087619",
            "telephone_number": "336-273-7900",
            "fax_number": "336-482-3517"
        }
    ],
    "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": "2012-02-15",
        "last_updated": "2013-06-03",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Southeastern Heart and Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.