NPIMap

Organization Active NPI

Eagle Physicians and Associates PA

Doing business as Eagle Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
National Provider Identifier
1396852570
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
AS0075 Issued in NC
Legal business name
EAGLE PHYSICIANS AND ASSOCIATES PA
Doing business as
Eagle Endoscopy Center
Practice address
1002 N Church St
Suite 2
Greensboro, NC 27401-1439
Phone
(336) 268-3880
Fax
(336) 268-3881
NPI assigned
Aug 24, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
EAGLE PHYSICIANS AND ASSOCIATES PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Authorized official

Name
Terri S. Jones
Title
Director, Eagle Business Services
Phone
(336) 268-3201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AS0075 NC Primary

Addresses

Primary practice location

1002 N Church St
Suite 2
Greensboro, NC 27401-1439

Mailing address

PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 268-3880

Other identifiers 3

IdentifierTypeStateIssuer
3409942MedicaidNC
0061XOtherNCBCBS OF NC GROUP
018A4OtherNCBCBS OF NC

Other names 1

  • Eagle Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000416 NC Part B Supplier - Ambulatory Surgical Center 0244134468 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, NC

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Eagle Physicians and Associates PACCN 34C0001117
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1052230Eagle Endoscopy Center1002 N Church St Ste 201, Greensboro, NC 27401Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Tannenbaum Eagle Prim P11 organizations share this tax ID, including this one
Part of
Tannenbaum Eagle Prim P

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1002 N Church St
Ste 2
Greensboro, NC 27401
Phone (336) 268-3880

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 118

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 118

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1396852570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-268-3880",
            "fax_number": "336-268-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "SUITE 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-268-3880",
            "fax_number": "336-268-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE PHYSICIANS AND ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE PHYSICIANS AND ASSOCIATES PA",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR, EAGLE BUSINESS SERVICES",
        "authorized_official_telephone_number": "336-268-3201"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409942",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC GROUP",
            "identifier": "0061X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "018A4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Endoscopy 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 Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.