Forsyth Memorial Hospital Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL INC

Doing business as

Novant Health Mountainview Medical

Practice address

216 Moore Rd
King, NC 27021-8703

Phone

(336) 983-4346

Fax

(336) 985-5101

NPI assigned

May 2, 2006

Last updated

Jul 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leea Jeanine Walton

Title

RCS Manager

Phone

(704) 316-6081

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Novant Health Mountainview Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Aaron Michael Boals, MD

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1750369724
  NPD
• Vanessa Renee Church, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Pilot Mountain, NC
  • NPI 1235894056
  NPD
• Eboni Malkia Ellis Farabee, M.D.

  • Family Medicine Physician
  • King, NC
  • NPI 1356575211
  NPD
• James Edward Jewell, MD

  • Internal Medicine Physician
  • King, NC
  • NPI 1760454474
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1497713234",
    "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",
            "telephone_number": "704-417-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MOORE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218703",
            "telephone_number": "336-983-4346",
            "fax_number": "336-985-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890224P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA1315",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Mountainview Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Mountainview Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Myrick Fievet
• Emily Marion Fischer, NP-C
• Candice Cain Fix, OD
• Jason Flake, LCSWA
• Foothills Eye Care, O.D., P.a.
• Foundation Health Systems Corp (Edwin H. Martinat Outpatient Comprehensive Rehabilitation Ctr -King)
• Kerry F Fox, PA
• William R Fox, M.D.
• Jamie Frazier
• Stephanie Amber Freeman, PMHNP

• Family Medicine Physician in King, NC
• Providers in King, 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 Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.