Organization Active NPI

SBN Incorporated

  • Psychiatry Physician
  • Greensboro, NC
National Provider Identifier
1598850844
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SBN INCORPORATED
Practice address
2401 S Side Blvd
Greensboro, NC 27406-3311
Phone
(919) 491-3455
Fax
(919) 859-5225
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Authorized official

Name
Dr. Mohammad Fahim-Danish Lateef, M.DNPI 1962445668
Title
President of the Company
Phone
(919) 491-3455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2401 S Side Blvd
Greensboro, NC 27406-3311

Mailing address

25 Winding Ridge Rd
Durham, NC 27713-5811

Other identifiers 1

IdentifierTypeStateIssuer
1962445668OtherNCINDIVIDUAL NPI NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051012000294 NC Part B Supplier - Clinic/Group Practice 9335164052 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1598850844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WINDING RIDGE RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S SIDE BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274063311",
            "telephone_number": "919-491-3455",
            "fax_number": "919-859-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBN INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "LATEEF",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "FAHIM-DANISH",
        "authorized_official_title_or_position": "PRESIDENT OF THE COMPANY",
        "authorized_official_telephone_number": "919-491-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL  NPI NUMBER",
            "identifier": "1962445668",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.