Organization Active NPI

Surry Medical Specialists, PA

  • Specialist
  • Mount Airy, NC
National Provider Identifier
1437118155
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19746 Issued in NC
Legal business name
SURRY MEDICAL SPECIALISTS, PA
Practice address
708 S South St
Mount Airy, NC 27030-4426
Phone
(336) 786-6146
Fax
(336) 786-8973
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles R Bokesch, MDNPI 1184617722
Title
Medical Director
Phone
(336) 786-6146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 19746 NC Primary

Addresses

Primary practice location

708 S South St
Mount Airy, NC 27030-4426

Mailing address

708 S South St
Mount Airy, NC 27030-4426
Phone (336) 786-6146

Other identifiers 1

IdentifierTypeStateIssuer
8902781MedicaidNC

National Provider Directory

National Provider Directory

Locations

708 S South St
Ste 200
Mount Airy, NC 27030
Phone 3367864522 ext. 3352

Practitioners & affiliated clinicians

Practitioners 1

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": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437118155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304426",
            "telephone_number": "336-786-6146",
            "fax_number": "336-786-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304426",
            "telephone_number": "336-786-6146",
            "fax_number": "336-786-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRY MEDICAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOKESCH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "336-786-6146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "19746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902781",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.