NPIMap

Organization Active NPI

Acts Signature Community Services, Inc.

Doing business as Primary Care Services at Tryon Estates

  • Internal Medicine Physician
  • Columbus, NC
National Provider Identifier
1487056578
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ACTS SIGNATURE COMMUNITY SERVICES, INC.
Doing business as
Primary Care Services at Tryon Estates
Practice address
617 Laurel Lake Drive
Columbus, NC 28722-7420
Phone
(828) 894-3000
Fax
(828) 894-2959
NPI assigned
Sep 19, 2014
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Susan Ahern
Title
SVP, Cfo
Phone
(215) 661-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

617 Laurel Lake Drive
Columbus, NC 28722-7420

Mailing address

420 Delaware Dr
Fort Washington, PA 19034-2711
Phone (267) 787-4097

Other names 1

  • Primary Care Services at Tryon Estates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150217000898 NC Part B Supplier - Clinic/Group Practice 1951212380 Receives reassigned benefits from 6 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, NC; Matthews, NC
O20160517001001 NC Part B Supplier - Clinic/Group Practice 5092032284 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, NC; Matthews, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Acts Sig Comm Srvcs28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

740 Pavilion View Dr
Matthews, NC 28105
Phone (704) 709-2538

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1487056578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342711",
            "telephone_number": "267-787-4097",
            "fax_number": "215-699-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LAUREL LAKE DRIVE",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287227420",
            "telephone_number": "828-894-3000",
            "fax_number": "828-894-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTS SIGNATURE COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "215-661-8330"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Services at Tryon Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.