NPIMap

Organization Active NPI

Forsyth Memorial Hospital Inc

Doing business as Novant Health Rheumatology and Arthritis ast WSHC

  • Rheumatology Physician
  • Winston Salem, NC
National Provider Identifier
1497183206
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
FORSYTH MEMORIAL HOSPITAL INC
Doing business as
Novant Health Rheumatology and Arthritis ast WSHC
Practice address
250 Charlois Blvd
Winston Salem, NC 27103-1508
Phone
(336) 896-1477
NPI assigned
Oct 15, 2013
Last updated
Oct 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Authorized official

Name
Geoffrey Keith Gardner
Title
VP of Finance
Phone
(336) 896-1477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Primary

Addresses

Primary practice location

250 Charlois Blvd
Winston Salem, NC 27103-1508

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other names 1

  • Novant Health Rheumatology and Arthritis ast WSHC 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

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1497183206",
    "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": "250 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031508",
            "telephone_number": "336-896-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "336-896-1477"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Rheumatology and Arthritis ast WSHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.