NPIMap

Organization Active NPI

Forsyth Memorial Hospital, Inc.

Doing business as Novant Health Spine Specialists

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Advance, NC
National Provider Identifier
1467955344
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
FORSYTH MEMORIAL HOSPITAL, INC.
Doing business as
Novant Health Spine Specialists
Practice address
5380 US Highway 158 Ste 110
Advance, NC 27006-6974
Phone
(336) 893-3210
Fax
(336) 893-3229
NPI assigned
Mar 16, 2018
Last updated
Apr 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Authorized official

Name
Geoffrey Gardner
Title
VP of Finance
Phone
(336) 718-2078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X Primary

Addresses

Primary practice location

5380 US Highway 158 Ste 110
Advance, NC 27006-6974

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other names 1

  • Novant Health Spine Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001702 NC Part B Supplier - Clinic/Group Practice 9537071790 Receives reassigned benefits from 1,329 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Novant Health58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1467955344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 US HIGHWAY 158 STE 110",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270066974",
            "telephone_number": "336-893-3210",
            "fax_number": "336-893-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "336-718-2078"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Spine Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Spine Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Advance, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.