Carolina Medicorp Enterprises, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CAROLINA MEDICORP ENTERPRISES, INC

Practice address

111 Gateway Center Dr
Dba Primecare Kernersville
Kernersville, NC 27284-2999

Phone

(336) 996-2173

Fax

(336) 996-3254

NPI assigned

May 2, 2006

Organization subpart

Yes

Parent organization

CAROLINA MEDICORP ENTERPRISES, INCAs reported in NPPES

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

Authorized official

Name

Paul M. Barry, MD

Title

Medical Director

Phone

(336) 774-0040

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Primce care of Kernersville Doing business as

Part of

Prmecare Medical Center

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1710945696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FRONTIS PLAZA BLVD STE 200",
            "address_2": "(ATTN) FORSYTH MEDICAL GROUP",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035616",
            "telephone_number": "336-277-2435",
            "fax_number": "336-277-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GATEWAY CENTER DR",
            "address_2": "DBA PRIMECARE KERNERSVILLE",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842999",
            "telephone_number": "336-996-2173",
            "fax_number": "336-996-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA MEDICORP ENTERPRISES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA MEDICORP ENTERPRISES, INC",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "336-774-0040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primce care of Kernersville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Care2Loveinaction
• Carenet, Inc.
• Shawn William Carey, PT
• Jennifer Carlson-Long, PTA
• Constance Carlton
• Carolina Physical Therapy Specialists, Inc
• Carolina Urological Associates, P.a.
• Kayla Rene' Carpenter, RN, LMBT
• Joel Sergio Carrera, PHARM.D.
• Terry Carter, LCSW

• 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 Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.