NPIMap

Organization Active NPI

Piedmont Senior Care, PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Greensboro, NC
National Provider Identifier
1770566846
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PIEDMONT SENIOR CARE, PLLC
Practice address
1309 N Elm Street
Greensboro, NC 27401
Phone
(336) 544-5400
Fax
(336) 544-5401
NPI assigned
Nov 22, 2005
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Mrs. Amelita Samera Rodriguez
Title
HR/BM
Phone
(336) 544-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NC Primary

Addresses

Primary practice location

1309 N Elm Street
Greensboro, NC 27401

Mailing address

1309 N Elm Street
Greensboro, NC 27401
Phone (336) 544-5400

Other identifiers 2

IdentifierTypeStateIssuer
89013NHMedicaidNC
013NHOtherNCBLUE CROSS BLUE SHIELD

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
34D1008173Piedmont Senior Care1309 North Elm Street, Greensboro, NC 27401Provider-performed microscopyJan 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1770566846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT SENIOR CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "AMELITA",
        "authorized_official_middle_name": "SAMERA",
        "authorized_official_title_or_position": "HR/BM",
        "authorized_official_telephone_number": "336-544-5400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013NH",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "013NH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.