Eagle Physicians and Associates PA
Organization Active NPI Internal Medicine Physician · Greensboro, NC
NPI 1457423907 · NPPES record last updated Sep 24, 2015
Key facts
- NPI
- 1457423907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- EAGLE PHYSICIANS AND ASSOCIATES PA
- Practice address
- 301 E Wendover Ave
Suite 200
Greensboro, NC 27401-1230 - Phone
- (336) 274-3241
- Fax
- (336) 268-4444
- NPI assigned
- Nov 13, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- EAGLE PHYSICIANS AND ASSOCIATES PA
Authorized official
- Name
- Terri S. Jones
- Title
- Director, Eagle Business Services
- Phone
- (336) 268-3201
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 12
Practitioners 14
-
Julie Beth Bain, PA
-
Karen Glass, CRNA
-
John Griffin, MD
-
William R Harris, M.D.
-
Jennifer Rose Humphreys, CRNA
-
Karen Akosua Schooler, M.D.
-
Hal T Stoneking, MD
-
Jennifer Reeves Willard, PA-C
-
Meagan Younts, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D1036729 | Eagle Internal Medicine at Tannenbaum | Certificate of waiver | Feb 7, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031120000436 | NC | Part B Supplier - Clinic/Group Practice | 0244134468 |
Receives reassigned benefits from 207 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Oak Ridge, NC; Greensboro, NC |
National Provider Directory
- Part of
- Eagle Sleep Center
Locations
3511 W Market St
Ste 250
Greensboro, NC 27403
Phone (336) 852-3800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes | ||
| Gastroenterology Physician |
207RG0100X | |||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | |||
| Rheumatology Physician |
207RR0500X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
301 E Wendover Ave
Suite 200
Greensboro, NC 27401-1230
Mailing address
PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 274-3241
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0134T | Other | NC | BCBS OF NC |
| 890134T | Medicaid | NC |
Other names
- Eagle Internal Medicine at Tannenbaum
Other providers in Greensboro, NC
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
- Eagle Physicians and Associates PA
All providers in Greensboro, NC · Internal 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 Sep 24, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.