NPIMap

Organization Active NPI

Forsyth Memorial Hospital Inc

  • Hematology & Oncology Physician
  • Winston Salem, NC
National Provider Identifier
1679945299
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
FORSYTH MEMORIAL HOSPITAL INC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 277-6009
NPI assigned
Oct 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Geoffrey K Gardner
Title
VP of Finance
Phone
(336) 277-6009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X NC Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X NC

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-6009

Other names 1

  • Novant Health Cancer Genetics Counseling 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

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1679945299",
    "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": "336-277-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-277-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSYTH MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "336-277-6009"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Cancer Genetics Counseling Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.