Carolina Medicorp Enterprises Inc
Organization Active NPI Family Medicine Physician · Greensboro, NC
NPI 1447634191 · NPPES record last updated Jul 13, 2015
Key facts
- NPI
- 1447634191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CAROLINA MEDICORP ENTERPRISES INC
- Practice address
- 4012 Battleground Ave Ste B
1020
Greensboro, NC 27410-8592 - Phone
- (336) 564-4341
- NPI assigned
- Jul 13, 2015
- Organization subpart
- No
Authorized official
- Name
- Geoffery Gardner
- Title
- VP Finance
- Phone
- (336) 564-4341
Other NPIs on the same Medicare enrollment 32
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040110000190 | NC | Part B Supplier - Clinic/Group Practice | 0648174904 |
Receives reassigned benefits from 249 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cornelius, NC; Greensboro, NC; High Point, NC; Huntersville, NC; Indian Trail, NC; Kernersville, NC; Lexington, NC; Matthews, NC… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician |
207PE0004X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
4012 Battleground Ave Ste B
1020
Greensboro, NC 27410-8592
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 564-4341
Other names
- Novant Health Express Care
Other providers in Greensboro, NC
- Carolina Eye Surgical and Laser Center
- Carolina Homes for Youth Inc
- Carolina Kidney Associates PA
- Carolina Lifestyles Senior Care, Inc
- Carolina Medical Health Supply LLC
- Carolina Medicorp Enterprises, Inc
- Carolina Medicorp Enterprises, Inc
- Carolina Medicorp Enterprises, Inc
- Carolina Medicorp Enterprises, LLC
- Carolina Mobility & Seating, Inc.
All providers in Greensboro, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.