Active NPI
Forsyth Memorial Hospital, Inc
Doing business as Medical Associates of Surry
- Family Medicine Physician
- Mount Airy, NC
National Provider Identifier
1598723488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FORSYTH MEMORIAL HOSPITAL, INC
- Doing business as
- Medical Associates of Surry
- Practice address
- 865 W Lake Dr
Mount Airy, NC 27030-2157 - Phone
- (336) 719-6100
- Fax
- (336) 719-2313
- NPI assigned
- May 2, 2006
- Last updated
- Aug 24, 2010
- Organization subpart
- Yes
- Parent organization
- FORSYTH MEMORIAL HOSPITAL, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffery Lindsay
- Title
- President of FMC
- Phone
- (336) 718-2056
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
865 W Lake Dr
Mount Airy, NC 27030-2157
Mailing address
1718 E 4TH St
Suite 902
Charlotte, NC 28204-3261
Phone (336) 719-6100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5902732 | Medicaid | NC | |
| CA1315 | Other | NC | RAILROAD MEDICARE |
Other names 1
- Medical Associates of Surry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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- Part of
- Forsyth Mem Hosp Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1282608000000",
"number": "1598723488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1718 E 4TH ST",
"address_2": "SUITE 902",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043261",
"telephone_number": "336-719-6100",
"fax_number": "336-719-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 W LAKE DR",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270302157",
"telephone_number": "336-719-6100",
"fax_number": "336-719-2313"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FORSYTH MEMORIAL HOSPITAL, INC",
"enumeration_date": "2006-05-02",
"last_updated": "2010-08-24",
"status": "A",
"authorized_official_last_name": "LINDSAY",
"authorized_official_first_name": "JEFFERY",
"authorized_official_title_or_position": "PRESIDENT OF FMC",
"authorized_official_telephone_number": "336-718-2056"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5902732",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CA1315",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medical Associates of Surry",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Airy, NC
- Elizabeth Nail Ford, DPT
- Forsyth Memorial Hospital Inc (Novant Health Surry Medical Associates)
- Forsyth Memorial Hospital Inc (Novant Health Cancer Institute)
- Forsyth Memorial Hospital, Inc (Novant Health Surry Medical Associates)
- Forsyth Memorial Hospital, Inc (Novant Health Cardiology Mount Airy)
- Cindy Fortner, CRNA
- Foundation Health Systems Corp (Edwin H. Martinat Comprehensive Outpatient Rehabilitation Center)
- Aaron M France, D.O.
- Robin M France, DPM
- Franklyn Health Investors Inc. (North Main Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.