Wake Forest University Baptist Medical Center Community Physicians

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS

Doing business as

Foothills Primary Care

Practice address

910 Worth St
Foothills Primary Care
Mount Airy, NC 27030-4458

Phone

(336) 786-5108

Fax

(336) 783-6842

NPI assigned

Aug 23, 2005

Organization subpart

Yes

Parent organization

WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Mr. Lewis S Thorp III

Title

President Ceo

Phone

(336) 721-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Foothills Primary Care Doing business as

Part of

Peace Haven Urgent Care

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wake Forest University Baptist Medical Center Community Physicians

  • Family Medicine Physician
  • Statesville, NC
  • NPI 1417940636
  NPPES parent name

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1477546620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WORTH ST",
            "address_2": "FOOTHILLS PRIMARY CARE",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304458",
            "telephone_number": "336-786-5108",
            "fax_number": "336-783-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WORTH ST",
            "address_2": "FOOTHILLS PRIMARY CARE",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304458",
            "telephone_number": "336-786-5108",
            "fax_number": "336-783-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "THORP",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "336-721-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "2317728",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890123T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothills Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josue Alejandro Villegas-Silva
• Vitamind Counseling PLLC
• Cortland Caroline Voelkel, PA-C
• Anna Grace Wagoner
• Christopher Chad Wagoner
• Wake Forest University Health Sciences
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Walgreen Co

• Family Medicine Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.