Forsyth Memorial Hospital, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORSYTH MEMORIAL HOSPITAL, INC

Doing business as

Novant Health Kernersville Family Medicine

Practice address

291 Broad St
Kernersville, NC 27284-2932

Phone

(336) 993-8181

Fax

(336) 996-9539

NPI assigned

May 2, 2006

Last updated

Jul 11, 2023By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 2

Other names 1

• Novant Health Kernersville Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

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.

• Brittany Bell Everett, NP-C

  • Nurse Practitioner
  • King, NC
  • NPI 1144678764
  NPD
• Joseph Michael Gray, AGNP

  • Nurse Practitioner
  • Kernersville, NC
  • NPI 1427672682
  NPD
• Breland Meany Joines, PA-C

  • Physician Assistant
  • Greensboro, NC
  • NPI 1629228374
  NPD
• Alexei Radiontchenko, MD

  • Family Medicine Physician
  • Kernersville, NC
  • NPI 1619993946
  NPD
• Jeffrey Lynn Vanderburg, NP

  • Nurse Practitioner
  • Kernersville, NC
  • NPI 1487117461
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1679531495",
    "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": "282602362",
            "telephone_number": "336-993-8181",
            "fax_number": "336-996-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 BROAD ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842932",
            "telephone_number": "336-993-8181",
            "fax_number": "336-996-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA1315",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901969",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Kernersville Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Kernersville Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Forsyth Memorial Hospital, Inc (CRNA Kernersville)
• Forsyth Memorial Hospital, Inc (Novant Health Rheumatology and Arthritis)
• Forsyth Memorial Hospital, Inc (Novant Health Urology)
• Forsyth Memorial Hospital, Inc (Kernersville Critical Care)
• Forsyth Memorial Hospital, Inc (Professional Services of Kernersville)
• Forsyth Memorial Hospital, Inc (Urology Partners-Kernersville)
• Forsyth Memorial Hospital, Inc (Rheumatology & Arthritis Associates)
• Forsyth Memorial Hospital, Inc.
• Forsyth Radiological Associates (Central Triad Imaging Center)
• Drew Forsyth

• Family Medicine Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Family Medicine Physician in North Carolina

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.