NPIMap

Organization Active NPI

Piedmont Healthcare, PA

  • Internal Medicine Physician
  • Statesville, NC
National Provider Identifier
1710450002
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PIEDMONT HEALTHCARE, PA
Practice address
1669 Davie Ave
Statesville, NC 28677-3519
Phone
(704) 978-3571
Fax
(704) 838-0706
NPI assigned
Jan 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Greg Guin
Title
Cfo
Phone
(704) 873-4277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1669 Davie Ave
Statesville, NC 28677-3519

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0969016Piedmont Healthcare PA1669 Davie Ave, Statesville, NC 28677Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Piedmont Healthcare40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 6

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": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1710450002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773519",
            "telephone_number": "704-978-3571",
            "fax_number": "704-838-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT HEALTHCARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "GUIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-873-4277"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.