Organization Active NPI

Cornerstone Health Care, PA

Doing business as Piedmont Centre Family Medicine

  • Sports Medicine (Family Medicine) Physician
  • High Piont, NC
National Provider Identifier
1669605523
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
CORNERSTONE HEALTH CARE, PA
Doing business as
Piedmont Centre Family Medicine
Practice address
4515 Premier Drive
Suite 201
High Piont, NC 27265-8350
Phone
(336) 802-2350
Fax
(336) 802-2351
NPI assigned
Aug 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Grace E Terrell
Title
President / Ceo
Phone
(336) 802-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

4515 Premier Drive
Suite 201
High Piont, NC 27265-8350

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27262-7254
Phone (336) 802-2536

Other identifiers 1

IdentifierTypeStateIssuer
5913057MedicaidNC

Other names 1

  • Piedmont Centre Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000868 NC Part B Supplier - Clinic/Group Practice 4183538895 Receives reassigned benefits from 690 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Jefferson, NC; Jonesville, NC; Kernersville, NC; Summerfield, NC; Thomasville, NC; Winston Salem, NC; Archdale, NC…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1669605523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DRIVE",
            "address_2": "SUITE 201",
            "city": "HIGH PIONT",
            "state": "NC",
            "postal_code": "272658350",
            "telephone_number": "336-802-2350",
            "fax_number": "336-802-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HEALTH CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "336-802-2400"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913057",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Centre Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in High Piont, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.