Individual provider Active NPI

Louise I Nordbladh, PA-C

  • Medical Physician Assistant
  • Greensboro, NC
National Provider Identifier
1720399322
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-02364 Issued in NC
Practice address
1132 N Church St
Greensboro, NC 27401-1039
Phone
(336) 358-4268
Fax
(336) 691-1704
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-02364 NC Primary

Addresses

Primary practice location

1132 N Church St
Greensboro, NC 27401-1039

Mailing address

1701 Westchester Dr
Suite 850
High Point, NC 27262-7008
Phone (336) 802-2536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000155 NC Practitioner - Physician Assistant 6002949138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

1132 N Church St
Suite 200
Greensboro, NC 27401-1040
Phone (336) 379-9445

770 Highland Oaks Dr
Winston Salem, NC 27103-7105
Phone (336) 765-5250

905 Phillips Ave
High Point, NC 27262-7075
Phone (336) 802-2040

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02364NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network LLC CurrentSince Jul 1, 2012 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jul 1, 2012 Accepting new patients
Wake Forest Health Network LLC Past Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

1132 N Church St
Ste 200
Greensboro, NC 27401
Phone (336) 358-4268

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1720399322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627008",
            "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": "1132 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011039",
            "telephone_number": "336-358-4268",
            "fax_number": "336-691-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDBLADH",
        "first_name": "LOUISE",
        "middle_name": "I",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.