NPIMap

Organization Active NPI

Stokes Reynolds Memorial Hospital, Inc.

Doing business as Stokes Medical Associates-Pediatrics

  • Pediatrics Physician
  • Danbury, NC
National Provider Identifier
1437330644
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
STOKES REYNOLDS MEMORIAL HOSPITAL, INC.
Doing business as
Stokes Medical Associates-Pediatrics
Practice address
1030 Hospice Drive
Danbury, NC 27016-1030
Phone
(336) 593-5354
Fax
(336) 593-5331
NPI assigned
Nov 15, 2007
Last updated
Feb 18, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
STOKES REYNOLDS MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Pamela P Tillman
Title
Chief Operating Officer
Phone
(336) 593-5314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1030 Hospice Drive
Danbury, NC 27016-1030

Mailing address

PO Box 10
Danbury, NC 27016-0010
Phone (336) 593-5354

Other identifiers 2

IdentifierTypeStateIssuer
235111FOtherNCMEDICARE PTAN GROUP#
5908390MedicaidNC

Other names 1

  • Stokes Medical Associates-Pediatrics Doing business as

National Provider Directory

National Provider Directory
Part of
Stokes Reynolds Memoria

Member of 2

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

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1437330644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "DANBURY",
            "state": "NC",
            "postal_code": "270160010",
            "telephone_number": "336-593-5354",
            "fax_number": "336-593-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HOSPICE DRIVE",
            "city": "DANBURY",
            "state": "NC",
            "postal_code": "270161030",
            "telephone_number": "336-593-5354",
            "fax_number": "336-593-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOKES REYNOLDS MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STOKES REYNOLDS MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2007-11-15",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "336-593-5314"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP#",
            "identifier": "235111F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908390",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stokes Medical Associates-Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.