Covenant Clinic, P. a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25545 Issued in NC

Legal business name

COVENANT CLINIC, P. A.

Practice address

7953 Villanow Dr
Sanford, NC 27332-7595

Phone

(919) 774-4163

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thellie Rupert Ainsley Jr., M. D.

Title

President

Phone

(919) 774-4163

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1407977804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2427",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273312427",
            "telephone_number": "919-774-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7953 VILLANOW DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273327595",
            "telephone_number": "919-774-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CLINIC, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "AINSLEY",
        "authorized_official_first_name": "THELLIE",
        "authorized_official_middle_name": "RUPERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-774-4163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "25545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "DN4531",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950617",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Lee North Carolina
• Reagan Courliss, M.ED.,NCC, LCMHC
• Matthew A Cournoyer
• Eileen Shannon Courtleigh, P.A.
• Sarah Ann Courtright, MA, LPCA
• Jenae Tonille Cox, LCSW
• Marcus Cox, PA-C
• Meische Cox, PT, DPT, ATC
• Patti Morris Cox, PT
• Belinda Burch Crawford, MS, LCMHC, LCAS

• Internal Medicine Physician in Sanford, NC
• Providers in Sanford, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.