Organization Active NPI

Forsyth Memorial Hospital Inc

Doing business as Novant Health Osteoporosis Clinic

  • Internal Medicine Physician
  • Clemmons, NC
National Provider Identifier
1659718534
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FORSYTH MEMORIAL HOSPITAL INC
Doing business as
Novant Health Osteoporosis Clinic
Practice address
6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone
(336) 718-1680
Fax
(336) 718-1681
NPI assigned
May 31, 2013
Last updated
Jul 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

6915 Village Medical Cir
Clemmons, NC 27012-8002

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (704) 384-7840

Other practice location 1

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-1680

Other names 1

  • Novant Health Osteoporosis Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Locations

755 Highland Oaks Dr
Ste 201
Winston Salem, NC 27103
Phone (336) 765-0020

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1659718534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 VILLAGE MEDICAL CIR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128002",
            "telephone_number": "336-718-1680",
            "fax_number": "336-718-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-1680",
            "fax_number": "336-718-1681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Osteoporosis Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Osteoporosis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.