NPIMap

Organization Active NPI

Cornerstone Health Care PA

Doing business as Cornerstone Convenience Care Clinic at Premier

  • Family Medicine Physician
  • High Point, NC
National Provider Identifier
1720103609
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNERSTONE HEALTH CARE PA
Doing business as
Cornerstone Convenience Care Clinic at Premier
Practice address
4515 Premier Drive
Suite 201
High Point, NC 27265-8350
Phone
(336) 802-2222
Fax
(336) 802-2351
NPI assigned
Mar 20, 2007
Last updated
Nov 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Grace E Terrell, MDNPI 1598795478
Title
President / Ceo
Phone
(336) 802-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

4515 Premier Drive
Suite 201
High Point, NC 27265-8350

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27262-7254
Phone (336) 802-2536

Other names 1

  • Cornerstone Convenience Care Clinic at Premier Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000868 NC Part B Supplier - Clinic/Group Practice 4183538895 Receives reassigned benefits from 690 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Jefferson, NC; Jonesville, NC; Kernersville, NC; Summerfield, NC; Thomasville, NC; Winston Salem, NC; Archdale, NC…

National Provider Directory

National Provider Directory

Locations

4515 Premier Dr
Ste 201
High Point, NC 27265
Phone (336) 802-2610

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1720103609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DRIVE",
            "address_2": "SUITE 201",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658350",
            "telephone_number": "336-802-2222",
            "fax_number": "336-802-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HEALTH CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "336-802-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Convenience Care Clinic at Premier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.