NPIMap

Organization Active NPI

Surry Regional Health Services, Inc.

Doing business as DBA: Northern Medical Group Primary Care

  • Internal Medicine Physician
  • Mount Airy, NC
National Provider Identifier
1568869089
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SURRY REGIONAL HEALTH SERVICES, INC.
Doing business as
DBA: Northern Medical Group Primary Care
Practice address
314 S South St
Suite 800
Mount Airy, NC 27030-4491
Phone
(336) 786-4522
NPI assigned
Nov 26, 2014
Organization subpart
Yes
Parent organization
NORTHERN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Authorized official

Name
Gregory M Schulz
Title
VP Surry Regional Health Services
Phone
(336) 783-8353

Specialties & licenses 1

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

Addresses

Primary practice location

314 S South St
Suite 800
Mount Airy, NC 27030-4491

Mailing address

PO Box 1267
Mount Airy, NC 27030-1267
Phone (336) 786-4522

Other names 1

  • DBA: Northern Medical Group Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crnas of Mount Airy8 organizations share this tax ID, including this one
Part of
Northern Hosp of Surry Co

Other organizations with this tax ID 7

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

Locations

314 S South St
Ste 800
Mount Airy, NC 27030
Phone (336) 786-4522

NPI Registry JSON

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1568869089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270301267",
            "telephone_number": "336-786-4522",
            "fax_number": "336-786-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S SOUTH ST",
            "address_2": "SUITE 800",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304491",
            "telephone_number": "336-786-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRY REGIONAL HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN HOSPITAL",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP SURRY REGIONAL HEALTH SERVICES",
        "authorized_official_telephone_number": "336-783-8353"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA: Northern Medical Group Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.