NPIMap

Organization Active NPI

Moses Cone Affiliated Physicians, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Burlington, NC
National Provider Identifier
1689934994
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
MOSES CONE AFFILIATED PHYSICIANS, INC
Practice address
2921 Crouse LN
Burlington, NC 27215-8833
Phone
(336) 585-1212
Fax
(336) 585-1112
NPI assigned
May 21, 2012
Organization subpart
Yes
Parent organization
MOSES H. CONE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Mr. Kenneth Knight Boggs
Title
Cfo/Treasurer
Phone
(336) 832-8005

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Nuclear Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207UN0901X

Addresses

Primary practice location

2921 Crouse LN
Burlington, NC 27215-8833

Mailing address

1200 N Elm St
Asb, Suite 201
Greensboro, NC 27401-1004
Phone (336) 832-9513

Other names 1

  • Burlington Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000512 NC Part B Supplier - Clinic/Group Practice 3779635396 Receives reassigned benefits from 86 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Reidsville, NC; Oak Ridge, NC; Kernersville, NC; High Point, NC; Burlington, NC; Asheboro, NC

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory
Part of
Moses Cone Mem Hosp

Locations

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1689934994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "address_2": "ASB, SUITE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-9513",
            "fax_number": "336-832-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 CROUSE LN",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-585-1212",
            "fax_number": "336-585-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES CONE AFFILIATED PHYSICIANS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOSES H. CONE MEMORIAL HOSPITAL",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "KNIGHT",
        "authorized_official_title_or_position": "CFO/TREASURER",
        "authorized_official_telephone_number": "336-832-8005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlington Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.