NPIMap

Organization Active NPI

North Carolina Specialty Hospital LLC

  • Surgery Physician
  • Durham, NC
National Provider Identifier
1740996875
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTH CAROLINA SPECIALTY HOSPITAL LLC
Practice address
120 William Penn PLZ
Durham, NC 27704-2150
Phone
(919) 220-5255
NPI assigned
Jan 23, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

120 William Penn PLZ
Durham, NC 27704-2150

Mailing address

PO Box 15819
Durham, NC 27704-0819

Other practice location 1

100 Perkins Dr
Chapel Hill, NC 27514-1783
Phone (919) 942-3171

Other practice location 2

7850 Brier Creek Pkwy
Raleigh, NC 27617-8900
Phone (919) 846-3938

Other practice location 3

1111 Huffman Mill Rd
Burlington, NC 27215-8862
Phone (336) 584-5544

Other practice location 4

7810 Nc Highway 751
Durham, NC 27713-6924
Phone (919) 544-7270

Other practice location 5

799 Doctors Ct
Roxboro, NC 27573-4571
Phone (336) 599-4079

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230315001094 NC Part B Supplier - Clinic/Group Practice 1254386048 Receives reassigned benefits from 3 practitioners
Practice locations: Chapel Hill, NC; Durham, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Specialty Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Practitioners & affiliated clinicians

Practitioners 12

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": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1740996875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15819",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277040819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Perkins Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275141783",
            "country_code": "US",
            "telephone_number": "919-942-3171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7850 Brier Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276178900",
            "country_code": "US",
            "telephone_number": "919-846-3938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Huffman Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272158862",
            "country_code": "US",
            "telephone_number": "336-584-5544",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Nc Highway 751",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277136924",
            "country_code": "US",
            "telephone_number": "919-544-7270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "799 Doctors Ct",
            "address_purpose": "LOCATION",
            "city": "Roxboro",
            "state": "NC",
            "postal_code": "275734571",
            "country_code": "US",
            "telephone_number": "336-599-4079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH CAROLINA SPECIALTY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.