NPIMap

Organization Active NPI

Moses Cone Medical Services, Inc.

Doing business as Western Rockingham Family Medicine

  • Family Medicine Physician
  • Madison, NC
National Provider Identifier
1629376363
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOSES CONE MEDICAL SERVICES, INC.
Doing business as
Western Rockingham Family Medicine
Practice address
401 W Decatur St
Madison, NC 27025-1913
Phone
(336) 548-9618
Fax
(336) 548-4877
NPI assigned
Mar 4, 2011
Last updated
Jan 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
THE MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Sally Hammond
Title
Executive Director
Phone
(336) 663-5007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

401 W Decatur St
Madison, NC 27025-1913

Mailing address

300 E Wendover Ave
Greensboro, NC 27401-1229

Other identifiers 1

IdentifierTypeStateIssuer
024X3OtherNCBCBSNC

Other names 1

  • Western Rockingham Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040128000519 NC Part B Supplier - Clinic/Group Practice 2769395458 Receives reassigned benefits from 377 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; High Point, NC; Kernersville, NC; Madison, NC; Oak Ridge, NC; Reidsville, NC; Summerfield, NC; Whitsett, NC…
O20140416000469 NC Part B Supplier - Clinic/Group Practice 2769395458 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Whitsett, NC; Summerfield, NC; Reidsville, NC; Oak Ridge, NC; Madison, NC; Kernersville, NC; High Point, NC; Greensboro, NC…

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Moses Cone Mem Hosp

Locations

4023 Guilford College Rd
Greensboro, NC 27407
Phone (336) 890-2040

4810 W Wendover Ave
Jamestown, NC 27282
Phone (336) 547-8422

10046 Old Liberty Rd
Liberty, NC 27298
Phone (336) 622-3000

Practitioners & affiliated clinicians

Practitioners 364

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.

View all 364

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1629376363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W DECATUR ST",
            "city": "MADISON",
            "state": "NC",
            "postal_code": "270251913",
            "telephone_number": "336-548-9618",
            "fax_number": "336-548-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE MEDICAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2011-03-04",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-663-5007"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "024X3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Rockingham Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.