NPIMap

Organization Active NPI

Unc Rockingham Health Care, Inc.

Doing business as UNC Rockingham Family Medicine of Eden

  • Family Medicine Physician
  • Eden, NC
National Provider Identifier
1568967644
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNC ROCKINGHAM HEALTH CARE, INC.
Doing business as
UNC Rockingham Family Medicine of Eden
Practice address
515 Thompson St Ste D
Eden, NC 27288-5040
Phone
(336) 627-5178
NPI assigned
Mar 29, 2018
Last updated
Mar 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Hunter Walter Wagstaff
Title
Treasurer
Phone
(984) 974-1266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

515 Thompson St Ste D
Eden, NC 27288-5040

Mailing address

211 Friday Center Dr Ste 2057
Chapel Hill, NC 27517-9499
Phone (984) 974-1281

Other names 1

  • UNC Rockingham Family Medicine of Eden Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180605000262 NC Part B Supplier - Clinic/Group Practice 6800157181 Receives reassigned benefits from 80 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eden, NC; Mayodan, NC

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Unc Rockingham Health Care Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1568967644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FRIDAY CENTER DR STE 2057",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275179499",
            "telephone_number": "984-974-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 THOMPSON ST STE D",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885040",
            "telephone_number": "336-627-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNC ROCKINGHAM HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "WAGSTAFF",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "984-974-1266"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNC Rockingham Family Medicine of Eden",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNC Rockingham Family Medicine of Eden",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.